Seby B. Jones Regional Cancer Center

2 | Seby B. Jones Regional Cancer Center Annual Report

Seby B. Jones Regional Cancer CenterSeby B. Jones Regional Cancer Center, consisting of medical oncology and radiation oncology, opened in 1993 on the Watauga Medical Center campus. In 2002, an 8,000 square-foot addition was opened to accommodate the growing regional demand for medical oncology services. The Cancer Center offers a multidisciplinary approach to the prevention, diagnosis and treatment of cancers. Through advanced technology and a highly trained staff, the center offers exceptional diagnostic and treatment procedures that include radiation, chemotherapy, biotherapy, immunotherapy, prostate brachytherapy and hormonal treatments.

The Cancer Center was among the first facilities North Carolina to offer a new treatment modality called intensity modulated radiation therapy, or IMRT. This unique form of treatment is the most advanced method available to deliver high-dose radiation to destroy cancer cells while minimizing risk to normal tissues. IGRT (image guided radiation therapy) is the added component of a high quality x-ray system, or “on-board” imager, that allows quick and precise adjustments of a patient’s target volume for greater accuracy. Examples of sensitive tissues that can now be “sculpted” around include the prostate, spinal cord, optic nerve and salivary glands.

The American College of Surgeons awarded the Commission on Cancer® Three Year Certification of Accreditation to Seby B. Jones Regional Cancer Center in September 2016 and is accredited through 2019. The Cancer Center has been CoC accredited since 1997. Designation status: Accredited Community Cancer Program with six out of seven commendations.

2016 | 3

Advisory CommitteeDoc McCoy, ChairpersonAngie Shoemake, TreasurerBetty Mize, SecretarySandi Cassidy, Director of Oncology ServiceCandy Jones, Community OutreachMarjorie Hrozencik, RN, Clinical TrialsVicki Klinger, RN, NavigatorMelanie Childers, ChaplainMary Morgan, Avery County Community MemberLinda Nixon, Avery County Community MemberJoe Sinford, Watauga County Community MemberJulie Getty, Watauga County Community MemberBeth Andrews, Watauga County Community MemberSue Creech, Watauga County Community MemberMatthew Scott, Watauga County Community Member

Cancer Committee

Board Randy (Doc) McCoy, ChairpersonAngie Shoemake, Treasurer Betty Mize, Secretary Mark Saia, Community MemberTrina McCoy, Community MemberSusan Adams, Community MemberJoyce Watson, Avery County Community MemberVicki Stevens, Marketing and CommunicationsSandi Cassidy, Cancer Center AdministratorKindsay Reeder, Foundation Office Representative

Ad Hoc MembersKim Bianca, Sr. VP and CRA Executive SponsorRhonda McCoy, Lighting of the Tree Consultant

Cancer Resource Alliance

MembersDamon Anagnos, MD, Plastic SurgeonCamile Andrews, DO, Obstetrics & GynecologyAnne-Corinne Beaver, MD, Surgeon, Cancer Liaison PhysicianKim Bianca, RN, MSN, SVP, Clinical ServicesBeverly Bowen, PharmacistLinda Calderwood, CNP, Hospice & Palliative CareSandi Cassidy, Director, Oncology ServicesMelanie Childers, Director, Pastoral CareTammy Crumpler, MD, RadiologistBarbara Dean, PA, Medical OncologyTimothy Dailey, MD, Family MedicineAmy Freeman, MEd, CTR, Cancer RegistrarRobin Fox, RN, Director, Care ManagementDiane Gates, 9RN, Director, Birthing CenterT. Flint Gray, MD, Medical OncologistBrent Hall, MD, PathologistAngie Hicks, RN, VP QualityMarjorie Hrozencik, RN, Clinical Trials Nurse

The Cancer Committee is a multidisciplinary committee comprised of, but not limited to, representatives from surgery, medical oncology, radiation oncology, diagnostic radiology, pathology, administration, nursing, social services, cancer registry and quality assurance. The Cancer Committee is responsible for establishing the quality improvement priorities of the cancer program.

Candy Jones, RN, Community OutreachEddy Maillot, Director, Rehabilitation ServicesYvonne Mack, MD, Radiation OncologistTate Maddox, MD, OtolaryngologistBeth Miller, Director, Lab & ImagingBetty Mize, CTR, Cancer RegistrarCarrie Phillips, American Cancer SocietyTiffany Selong, DO, AnesthesiologistTony Schlake, MD, UrologistAngie Shoemake, MSW, Cancer Center Social WorkerDebbie Shook, RN, Director, Nursing AdministrationLaura Shroyer, Nutrition SpecialistAnna L. Sobol, MD, Cancer Committee Chair, Oncology Medical DirectorVicki Stevens, Director, Community OutreachDouglas Trate, MD, GastroenterologistKevin Wolfe, MD, PulmonologistPaul Young, RN, OCN, Oncology Nurse Navigator

The Cancer Resource Alliance (CRA) is a comprehensive team of healthcare professionals, business partners, cancer caregivers and cancer survivor volunteers. The Alliance was established in 2006 as an outreach arm of Seby B. Jones Regional Cancer Center in Watauga County, the American Cancer Society and the Rural Healthcare Initiative of Avery County. The CRA presence in Watauga and Avery counties is further committed to helping Seby B. Jones Regional Cancer Center qualifying patients and their families with support services and programs.


Cancer Committee Chair Annual Report2016 has been another year of growth for the Seby B. Jones Regional Cancer Center, and we are excited to share our progress with you.

The survivorship program, launched last year, continues to expand under the guidance of Barbara Dean, PA. Now under the new name of Rise Up: Your Path as a Survivor, the program includes chemotherapy teaching sessions, post-treatment visits to discuss expectations for recovery from chemotherapy-induced side effects, and activities to aid patients in recovery from treatment, including on-site yoga classes. The Cancer Center website is also being updated, making it easier for patients to sign up for programs in which they have an interest.

Our Financial and Nurse Navigators continue to provide invaluable patient support, including enrollment in programs to access medications at a discount and assistance with obtaining insurance coverage. The Nurse Navigator also assists in scheduling patients for on-site genetic counseling, a new service now available through a telemedicine partnership with Levine Cancer Institute.

Our program also completed the Commission on Cancer survey this year. This comprehensive review takes place every three years and includes a detailed review of standards, or guidelines, set at a national level. Preparation for the survey involves tremendous time, effort and attention to detail. I would like to thank everyone who participated, particularly our two superb Cancer Registrars.

We have also started a collaboration with the Physician Assistant Training Program Wake Forest Baptist Medical Center, with our first student completing a rotation at the Cancer Center in December 2016.

As always, many thanks to everyone in our community who has continued to support our efforts to provide the highest quality care to our patients in the High Country. Your kindness and generosity are very much appreciated. Thank you!

With warm regards,

Anna L. Sobol, MDOncology Medical DirectorCancer Committee Chair

Dr. Anna L. Sobol

2016 | 5

Medical Oncology

Radiation Oncology

Anna Sobol, MDDr. Sobol has worked at Seby B. Jones Regional Cancer Center since 2009. She is board certified in Medical Oncology and Internal Medicine by the American Board of Internal Medicine. She graduated from the University of Alabama School of Medicine in Birmingham in 2003. After graduation she completed an internship and residency program at the Mayo Clinic in Jacksonville, FL and a fellowship specializing in Hematology/Oncology at the Mayo Clinic.

Yvonne Mack, MDDr. Mack has worked for Seby B. Jones Regional Cancer Center since 1998. She is board certified in Radiation Oncology by the American Board of Radiology. She graduated from Wake Forest University School of Medicine in Winston-Salem in 1988. After graduation she completed an internship at Greenville Health System in Greenville, SC and a residency program at the University of Florida College of Medicine in Gainesville, FL.

T. Flint Gray, MDDr. Gray has worked at Seby B. Jones Regional Cancer Center since 1998. He is board certified in Medical Oncology, Internal Medicine and Hematology by the American Board of Internal Medicine. He graduated from Davidson College and then Emory University School of Medicine in 1987. After graduation he completed an internship and residency program at the University of North Carolina Hospital at Chapel Hill, specializing in Internal Medicine. He then completed Hematology and Medical Oncology Fellowships at UNC Hospital in Chapel Hill.

Barbara Dean, PA-CBarbara Dean, PA-C has worked at Appalachian Regional Healthcare System since 2012 and with the Seby B. Jones Regional Cancer Center since 2015. She grew up in a small town in upstate NY, and went on to receive her bachelor’s degree at Rochester Institute of Technology in 2001. She practiced in Internal Medicine, and then took an opportunity in Medical Oncology at Interlakes Hematology and Oncology in Rochester, NY. She relocated to Dallas, and began work at Texas Cancer Associates for three years. During that time, she also obtained her Master’s degree in Physician Assistant Studies.


Lessons learned from a television executive turned cancer survivorBy Josh Jarman, Community Liaison

As a young boy in Morgantown, West Virginia, Michael Fields can clearly remember the afternoon he walked home from school to discover a delivery man carrying a mystery box into his parent’s home.

Captivated by curiosity he stood at attention as the family’s first television came to life in their living room. From that moment on, Fields knew he wanted to go into show business. While his siblings played in the yard after school, he spent most of his childhood chasing story leads and shooting amateur news reports with his father’s eight-millimeter camera.

After college, Fields landed his first television job in Atlanta at WAGA as a floor man. His job consisted of hanging lights and sweeping the set between shows. After learning the business from the ground up, he went on to climb the ladder at major television stations in Pittsburgh, Chicago, Boston and New York City. Looking back, his favorite position along the way was Executive Vice President of QED Communications, where he became close friends with Fred Rogers – best known for Mr. Rogers Neighborhood.

In 2010, after a 50-year-career in television, Fields moved to Seven Devils, North Carolina, to semi-slowdown. Today, he is proud to share his industry knowledge with students as the General Manager of Appalachian State University’s AppTV station. Since its inception in 2015, Fields has served as the resident expert for launching the channel, which features a full range of programing produced by students through the Department of Communication.

“Working with our students is the most inspiring thing I have ever done,” said Fields with a smile. “AppTV has provided a platform for them to learn and for the world to witness the remarkable things taking place at Appalachian State.”

An unfortunate plot twist in Fields’ life story took place a few months ago when he discovered a walnut-sized growth on his thigh. After seeing a specialist in Charlotte, his physician confirmed the devastating diagnosis of high-grade myxofibrosarcoma. His doctor explained that treatment would require radiation followed by surgery, but the silver lining was that

he could receive his radiation treatment in Boone, North Carolina, at the Seby B. Jones Regional Cancer Center.

After returning to Boone, Fields went to the Cancer Center located just a few miles away from his home. There he met with Radiation Oncologist Dr. Yvonne Mack who explained that his cancer was treatable, but would require 25 consecutive days of radiation followed by surgery. Discouraged, Fields considered

his options and decided that at age 75 he had lived a good life and would let nature take its course.

Unwilling to give up, knowing how the cancer would painfully destroy his body, Dr. Mack called her patient a few days later in hopes of convincing him to reconsider. The two exchanged pleasantries, but Fields’ mind was made up. Equally stubborn in her resolve, Dr. Mack called him two more times to plead her case. Her persistence ultimately paid off. After her third call and a follow-up call from his physician in Charlotte, Fields decided to heed their advice and proceed with treatment.

“I’d say the biggest lesson learned throughout this whole experience has been that you cannot go through life thinking you know everything,” said Fields. “The medical professionals I was working with knew that my cancer could be treated and that it was worth the fight. Ultimately, I had to surrender my pride and trust their expertise.”

Six weeks had passed since his initial observation to his first day of treatment. During that time, his tumor

AppTV Studio with Michael Fields

had grown to the size of a small grapefruit and was threatening to spread to other parts of his body. Fields credits Dr. Mack and the Cancer Center for answering all of his questions with grace and making him feel comfortable in an uncomfortable situation.

As expected, by the third week of treatment, the radiation began to take its toll leaving Fields zapped of energy and unable to return to work. At that time, he considered giving up, but Dr. Mack remained unwavering in her support and reassured her patient to press on. At the conclusion of his treatment, the tumor had shrunk 30 percent, a very gratifying initial response. He then returned to Dr. Jeffrey Kneisl, his orthopedic oncologist, at the Levine Cancer Institute for a wide resection of his tumor on January 29, 2016. The surgery was completed without complication, and 90 percent of the tumor showed necrosis (killing of the cancer by his preoperative treatment) and today Fields is cancer free.

“Healthcare does not get better than what you find at Seby B. Jones Regional Cancer Center,” said Fields who was pleased to receive the bulk of his treatment close to home. “In this era, where healthcare has become painfully impersonal, where institutional hospitals are more concerned with research than patient care, this is the answer. Keep it small, keep it personal, keep it local and keep it well managed. That is what the Cancer Center at Appalachian Regional Healthcare System represents to me. I am a satisfied customer and a grateful patient.”

Today, Fields has returned to his position at AppTV where he hopes to continue to teach, inspire and create opportunities for students to follow in his career footsteps. “I am a firm believer that regardless of how long you have been out of school, life continues to send you tests. If my story can encourage these students to stay the course and never give up, then I’d say that is a life worth sticking around for.”

Jennifer Anderson, RN, BSNJennifer Anderson, Clinical Team Lead, successfully completed all the requirements set forth by The May School of Nursing and Health Sciences at Lees McRae College and received her Bachelor of Science in Nursing (BSN) degree.

Larry Harralson (R)(T)(CT)Larry Harralson successfully completed all the requirements set forth by Washburn University and received his Radiation Thera-py degree and completed required clinicals at Catawba Valley Medical Center.

Marjorie Hrozencik RN, BSN, OCN, CCRPMarjorie Hrozencik successfully completed all the requirements set forth by the Society of Clinical Research Associates and was granted the designation of Certified Clinical Research Professional (CCRP) 11/1/16.

Betty Mize, BA, OTA, CTRBetty Mize successfully completed all the requirements set forth by the National Cancer Registrars Association and was granted the designation of Certified Tumor Registrar on 11/04/16.

Jenny Peele (R)(T)(CT)Jenny Peele successfully completed all the re-quirements set forth by Washburn University and received her Radiation Therapy degree and completed required clinicals at Watauga Medical Center. Angie Shoemake, MSW, CMSW, OSW-CAngie Shoemake successfully completed all the requirements set forth by the Association of Social Work Boards Masters Examination and was granted the designation of Certified Master Social Worker (CMSW). She also completed all the requirements set forth by the Board of Oncology Social Work and was granted the designation of Oncology Social Work Certification (OSW-C).

2016 Additional Staff Certifications

2016 | 7


Community Involvement

Health SplashSeby B. Jones Regional Cancer Center shared a table with the Cancer Resource Alliance and a mammography scheduler at Health Splash on June 8, 2016 at the Sloop Medical Office Plaza on the campus of Cannon Memorial Hospital, in Linville, NC. Health Splash is an annual health fair, sponsored by Appalachian Regional Healthcare System and the Williams YMCA, that offers free screenings and information about health and wellness services in the High Country. Three mammograms were scheduled and 109 people attended this event.

Pink Heals Tour Pink Heals Tours Pink Fire Truck visited Seby B. Jones Regional Cancer Center on September 9, 2016. This non-profit organization started in 2007 to help people battling cancer with a focus on women and what they mean to us in our daily lives. It has evolved into a mission to keep fundraising and donated dollars local to support women and families within the community. The pink fire trucks bring the Pink Heals Program to cities across America. Patients, staff and family members were invited to sign the pink fire truck on behalf of loved ones.

Thanksgiving meal provides joy!

This year, 45 Cancer Center patients and their families were provided with a delicious Thanksgiving meal on Wednesday, November 23rd. The donation was made possible thanks to Angie Shoemake, Oncology Social Worker at the Cancer Center, A Perfect Fit and the Cancer Patient Emergency Fund.

2016 | 9

Community Involvement

ARHS’s Fourth Annual

Pink Day

Lighting of the Tree 3rd Annual

Lighting of the TreeSeby B. Jones Regional Cancer Center’s Third Annual Lighting of the Tree ceremony was held on December 15, 2016. A special thanks to those who made the ceremony a success; Melanie Childers; Randy (Doc) McCoy; Watauga High School String Orchestra led by William Sell; Joey Clawson of Panoramic View Christmas Tree Farm; Cancer Resource Alliance (CRA) Volunteers; and The Blue Ridge Garden Club.

Shea Dee placing an ornament on the tree in memory of her husband

Employees, volunteers and community members at both Cannon Memorial Hospital and Watauga Medical Center, gathered for Pink Day on Friday, October 28, 2016. Celebrating breast cancer survivors and fighters, the system-wide annual event hosted more than 150 participants.

Featured guest speakers included Richard Sparks, ARHS CEO / President; Dr. Tom Haizlip, Tate Clinic; Ann Anderson, Breast Cancer Survivor; Brian Whitfield and Addison Cardwell, Foundation; Melanie Childers, ARHS Chaplain; and Martha Daniels and Gloria Payne, ARHS Imaging Services.

Each year at Pink Day, money is raised for the Wilma Redmond Fund. Named for a mammographer at Watauga Medical Center who lost her battle to breast cancer, the Wilma Redmond Fund supports breast cancer prevention by providing free first time mammograms to uninsured women.

In 2016, 252 mammograms (201 at OPIC and 51 at CMH) were provided utilizing this fund. In addition to selling pink apparel in the gift shops, Randy and Trina McCoy of Doc’s Rocks Gem Mine, contributed 11 stunning Rose Quartz jewelry pieces for a raffle. These combined efforts raised more than $1500 for this important fund.

Georgia Troxel of nutrition services, coordinated the impressive refreshment tables and Wren Bow provided musical entertainment.


Cancer Center at a Glance

New Cancer Cases Diagnosed at Watauga Medical CenterDates of Service 1/1/15 – 5/31/16

Diagnostic Radiology: PET, CT, MRI • Pathology • EBUS

Women’s Health Services: Digital & 3-D Mammography,

Stereotactic Needle Biopsy, Breast Ultrasound,

Breast Needle Localization • Laboratory

Free

Hea

lth F

airs,

Scre

ening

s & Prev

ention • Sun Safety

Smok

ing C

essa

tion P

rogra

m • Thri

ve Fit fo

r the Future

Phys

ician

Lec

ture

s • Pu

blic S

chool Education

Fitn

ess &

Well

ness

Center

• Healt

h Tips

Radiation Oncology: IMRT & IGRT

Nuclear M

edicine • Pain Management Clinic

Chemo & Non-Chemo OP Infusion

Clinical Trials • Medical Oncology

Support ServicesCancer Navigation Program:

RN Navigation, Financial Navigation,Social Resource Navigation, Breast Navigation, Counseling NavigationGenetic Counseling • Survivorship

Nursing Quality Council • Support GroupsPastoral Care • Medical Library

Rehabilitation Services • PharmacyCancer Conference/Tumor Board

Nutrition Counseling Volunteer Services

Palliative Care

Cancer Resource Allia

nce •

Ave

ry C

ance

r Res

ourc

e

Massage and Music

Th era

pies •

Ope

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rt St

udio

Lymphedema Th

era

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Wou

nd C

are

THRIVE Oncolog

y Pro

gram

• Ra

dian

ce

1 F 1

16 M8 F 24

3 M5 F 8

9 M15 F24

46 M60 F 106

101 M106 F 207

51 M40 F 91

2016 | 11

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5

Education and prevention are essential elements in the ongoing fight against cancer. The Community Out-reach team works to educate and provide screenings in the High Country to improve cancer awareness and early detection. Some of the activities used to reach that goal included:• Skin, Breast and Prostate Cancer screenings

(293 attendees)• Seventeen community health events provided

information about cancer prevention, healthy lifestyles, nutrition, physical activity, smoking cessation and information about Seby B. Jones Regional Cancer Center. (1,286 attendees)

• Sun Safety cancer awareness program provided to 5th grade students in Watauga County. Students received sunglasses, chapstick and information to help protect the whole family. (330 attendees)

• Hosted “Pink Day” event to support Breast Cancer Awareness Month (150 attendees; 12 mammograms scheduled during the event)

• Four education talks at the senior centers in Watauga County about nutrition, healthy lifestyles and cancer prevention (Average attendance, 14)

• 2nd grade health fair; 7th grade Career Day; 5th Grade Sun Safety; Back2School fairs (all grades); Avery Healthy Halloween (all grades); 9th Grade health fairs and Avery YMCA Healthy Kids (all ages) (2,175 attendees)

• CoC Standard 4.1 THRIVE Fit for the Future The Cancer Center’s 2016 prevention program, THRIVE Fit for the Future, is a weight management program that uses behavior modification, nutrition counseling and exercise to promote lifestyle changes and reduce the risk of cancer. The community-based THRIVE program is held at the Paul H. Broyhill Wellness Center. 2016 THRIVE Fit for the Future Participants 34 Participants 293.7 lbs Total Weight Loss 7 Cancer Center sponsored Scholarships

• CoC Standard 4.1 Youth Tobacco Initiation Prevention Educational Program This program was presented to 220 Healthful Living students during the 9th grade health fair at Watauga High School on November 8, 2016. This health fair was sponsored by Seby B. Jones Regional Cancer Center.

Skin Cancer ScreeningMay 6, 2016

Stage III & IV H&N Incidence Trend 2008-‐2012Stage III Stage IV

2008 2 32009 1 32010 5 92011 5 42012 3 5

4214 Observe for Changes83 Recommended Treatment of Biopsy

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Stage IV

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2008 2009 2010 2011 2012

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2008 2009 2010 2011 2012

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159 Skin Surveys by Boone Dermatology 74 No treatment needed 4 Continue to observe for changes 81 Recommended treatment or biopsy

Mammograms Scheduled at Community EventsMarch - November 2016

33 Mammograms Scheduled 21 Completed, all negative 7 Not done 5 Appointments pending

323


2008 2 32009 1 32010 5 92011 5 42012 3 5


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2008 2009 2010 2011 2012

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2008 2009 2010 2011 2012

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2008 2009 2010 2011 2012

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Prostate Cancer ScreeningJune - August 2016

96 Screened 89 Normal 7 Abnormal, recommended follow up


2008 2 32009 1 32010 5 92011 5 42012 3 5


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2008 2009 2010 2011 2012

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2008 2009 2010 2011 2012

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3 Smoking Cessation ProgramCommunity and employee education using QuitlineNC and counseling.QuitlineNCRegistered callers: Avery County 49, Watauga County 87Fax referrals: ARHS 100 (26 accepted services)ARHS Employee Wellness Program, One-on-One Counseling15 Individuals counseled3 Actively quitting3 Quit7 Withdrew before end of program - not quit or quit/relapsed2 Counseled - contemplation/never entered program

251 Smoking Cessation Education 136 Registered callers 100 Fax referrals 15 One-on-One counseling

4934147150512358

1 2 3 4 5

5491 Total Mammograms 323 Additional imaging recommended 3586 Negative 1427 Benign 98 Probably benign, recommended follow up 57 Suspicious for malignancy or malignant

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Community OutreachDates of Service 1/1/16 - 12/31/16

Prevention Education Community Health Screenings


2008 2 32009 1 32010 5 92011 5 42012 3 5


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2008 2009 2010 2011 2012

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2008 2 32009 1 32010 5 92011 5 42012 3 5


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2008 2009 2010 2011 2012

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2008 2009 2010 2011 2012

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CoC Standard 4.2 Mammograms

Diagnostic and Screening MammogramsJanuary 1 - December 2, 2016

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35861427

98 57

5217

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15100

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Community Partnership

Doc’s Rock Gem MineOn November 9, 2016, Randy and Trina McCoy, long-time owners of Doc’s Rocks Gem Mine, along with their son, D’Artagnan, presented Sandi Cassidy, Director of Oncology Services at Seby B. Jones Regional Cancer Center, with a check for $17,154 for the Cancer Resource Alliance. The donation is the result of their year-long fundraising efforts, as well as from their “Mining for a Cure” event, held in October. The McCoys donate 100% of the proceeds from the event.Since 2014, the McCoys have donated more than $46,000 to support the mission of the Cancer Center. We are truly grateful for their generosity and legacy of support.

The Pet PlaceCasey Brown, Manager at The Pet Place, presented a $150 check to the Cancer Center. In total, The Pet Place has contributed more than $350 to the Cancer Patient Emergency Fund since 2015. Brown said, “We like that the money raised, stays local and supports patients in our community.”

Casey Brown donates check on behalf of The Pet Place

Doc’s Rock Gem Mine presents check

Blue Ridge EnergiesIn honor of Breast Cancer Awareness Month, Blue Ridge Energies presented a check for $3,360 for Breast Cancer Treatment. The donation represents a penny for every gallon of propane delivered in Watauga County during the past year by the company’s pink “Fueling the Fight” delivery truck designed to increase breast cancer awareness.

Grover C. Robbins Golf TournamentThe 44th Annual Grover C. Robbins, Jr. Memorial Golf Tournament was held on October 11, 2016 at Grandfather Golf and Country Club. This year’s tournament had record participation with 27 teams raising a combined total of $31,606. A visionary of development, Grover C. Robbins, Jr., along with his brothers Harry and Spencer, created Tweetsie Railroad, Hound Ears Club, Beech Mountain, the Land of Oz, Linville Land Harbor, Goldfish Junction (today’s Dollywood) and The Reef Resort in the Virgin Islands. Over the years, the tournament has raised more than $1,200,000 to assist the Cancer Center with the diagnosis and treatment of cancer.

12th Annual Pretty In PinkOn June 17, 2016, the Pretty in Pink Fashion Show and Luncheon fundraiser, hosted at Grandfather Golf and Country Club, raised $11,682 for the Avery County Cancer Resource Center’s Patient Emergency Fund. This fund is available to patients in need who are residents ofAvery County.

2016 Pretty in Pink Models

Watauga High SchoolWatauga High School donated $1,700 to Oncology Nurse Training and $401.30 to WMC Cancer Patient Emergency Fund.

Additional External FundraisersMany clubs and organizations have raised money for The Cancer Center this year. Thank you to The Grandfather Golf and Country Club LGA, Blowing Rock Country Club LGA, Linville Land Harbor Game Day, Linville Land Harbor Golf Tournament and Saturday Night Dance as well as employees donating to the Wilma Redmond Mammography Fund. Together, these events raised $29,519 for the Cancer Center.

2016 | 13


VolunteersDates of Service 10/01/15 - 9/30/16

15 Volunteers clocked a total of 1011 hoursDolores Amoroso Della CritcherLisa DavisMichelle DeeDoris Glowa Francine GreenfieldPeggy HagamanJanice Johnson/Twinky

Mary Lee JonesBlake KrugerAndrea LongMark Saia Dema SpannVicki Stevens/JakeVivian Wright

Cancer Patient Emergency Fund10/01/15-09/30/16

CRA Funds10/01/15 - 9/30/16

In FY 2016, CRA funds were used in support of:-Radiance Program-Music Therapy-THRIVE Oncology-Art Classes-Pink Day-Massage Therapy -Lighting of the Tree

Transportation $25,485.00Utilities $14,663.77Medication $10,715.59Housing $8,049.49Miscellaneous $6,370.39Medical Supplies $2,551.39Medical Care $444.42Total $68,280.05

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Transportation $25,485.00Utilities $14,663.77Medication $10,715.59Housing $8,049.49Miscellaneous $6,370.39Medical Supplies $2,551.39Medical Care $444.42Total $68,280.05

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Transportation $25,485.00

Utilities $14,663.77

Medication $10,715.59

Housing $8,049.49

Miscellaneous $6,370.39

Medical Supplies $2,551.39

Medical Care $444.42

Total $68,280.05

37%

21%

12%

4%

16%

9%

1%



2016 Nursing & Allied Health Oncology TeleHealth Lecture Series * 12:00 – 1:00 p.m.

Speaker Lecture Topic January 13 Denniz Zolnoun, MD, MPH Handling Difficult Situation/Conversations with

Patients February 10 Hy Muss, MD Addressing the Needs of Breast Cancer Patients

Ages 70 and Older March 9 Samantha Meltzer-Brody,

MD Provider Burnout and Compassion Fatigue: How to Prevent and Mitigate Symptoms

April 13 Christine Rini, PhD Benefits of Social Support Systems for Cancer Patients

May 11 Rebecca Campo, PhD Mind/Body Therapies to Manage the Effects of Cancer Treatment

May 23 David Ollila, MD; Andrea Saccone Snyder, Hair Stylist, The Flow Beauty Project; Nancy Thomas, MD, PhD

CARE Behind the Chair--Melanoma Special Event

June 8 Thomas Shea, MD CAR T Cell Immunotherapy for Lymphoma and Leukemia

July 13 Rachel Peragallo Urrutia, MD

Public Health Approaches to HPV Prevention

August 10 Stephen Bernard, MD Oncologic Emergencies September 14 Juneko Grilley-Olson, MD Personalized Medicine in the Clinic October 12 Michelle Gardiner, PharmD,

BCOP, CPP Managing the Side Effects of Chemotherapy

November 9 Kirsten Nyrop, PhD Exercise, Obesity, and Cancer December 14 Geni Eng, MPH, DrPH

Jennifer Schaal, MD Beth Smith, RN, MSN, NE-BC

Accountability for Cancer Care through Undoing Racism & Equity (ACCURE)

* CNE and ASRT credits awarded to participants

2016 Medical Oncology TeleHealth Lecture Series 12:00 – 1:00 p.m.

Speaker Lecture Topic January 27 Bhisham Chera, MD and

Jose Pedro Zevallos, MD, MPH, FACS

HPV & Head/Neck Cancer Panel

February 24 Paola Gehrig, MD Obesity & Gynecological Malignancies March 23 Frances Collichio, MD Choosing Therapy for Melanoma & Managing Side

Effects April 27 Melissa Troester, PhD Updates in Breast Cancer Epidemiology and

Pathogenesis May 25 Dominika L. James, MD Cancer Pain Management June 8 Thomas Shea, MD CAR T Cell Immunotherapy for Lymphoma and

Leukemia June 22 Matthew Milowsky, MD Advances in Metastatic Prostate Cancer July 27 Donald Rosenstein, MD Special Considerations for Patients with Mental

Illness and Cancer August 24 Jared Weiss, MD Thoracic Oncology ASCO Update September 28 Stephanie Wheeler, PhD Health Disparities & Cancer Outcomes October 26 Federico Innocenti, MD,

PhD Pharmacogenomics & Individual Therapy Research

November 16 David van Duin, MD, PhD Infections in Cancer Patients ** CNE, ASRT and CME credits awarded to participants Speakers & topics subject to change Staff who attended these lectures: Physicians: 2 Nurses: 16 Allied Health: 37

Education

Wake Forest School of Medicine in conjunction with Northwest Area Health Education Center (AHEC):• Watauga Medical Society Monthly Continuing

Medical Education Lecture Series• Lectures related to cancer topics for 2016:

• “I Have a Spot” (Update on Lung Cancer)Donald D. Graham, MD, November 21

The University of North Carolina’s grant funded TeleHealth Medicine Education Program has many benefits:• The dedicated conference room has

bi-monthly “Lunch and Learn” Continuing Medical Education (CME) and Continuing Nursing Education (CNE) webinars via the donated live cam conferencing equipment.• Two physicians, 16 nurses, and 37 allied

health staff participated, each earning 1.0 + Continuing Education Credits (CEU) per session.

• The Oncologists, the Pathologist and the Cancer Liaison Physician received desktop bi-directional live cam video conferencing unit facilitating real-time participation with the UNC Lineberger Cancer Center physicians in weekly Cancer (tumor) Conferences.

Professional Relationships• American Cancer Society• American College of Surgeons Accredited by Commission on Cancer• Appalachian State University, College of Health Sciences• Carolinas Healthcare System - Levine Cancer Institute• University of North Carolina at Chapel Hill - Lineberger Cancer Center • Wake Forest School of Medicine

2016 | 15


Modern Subaru of Boone Thank you to the team at Modern Subaru of Boone for providing support and “warmth” to our patients at the Seby B. Jones Cancer Center. On June 29, 2016, the team delivered blankets, provided as part of a partnership between Subaru of America, Inc. and The Leukemia & Lymphoma Society, and shared words of encouragement and support with patients fighting various forms of cancer. This special event would not have been possible if it were not for the instrumental support and coordination of Adriane Lewis, a cancer survivor and long-time supporter of the Seby B. Jones Regional Cancer Center. From all of us at the Cancer Center, we would like to thank Adriane and Modern Subaru of Boone for investing in the lives of our patients and community.

Lollipops 4 CancerVolunteer and Breast Cancer Survivor, Joanie Venza delivered 9,500 lollipops, in 2,200 bundles, on behalf of Lollipops 4 Cancer to patients on November 28, 2016. Lollipops 4 Cancer was founded by Tamara Jara with the goal to give “a little something that hopefully will bring a smile to their face.”

Ms. Opal Gragg’s QuiltMs. Opal Gragg specializes in making antique Yo-Yo quilts. She offered this beautiful quilt to Dr. Gray as a patient thank you.

Baird’s Creek Presbyterian ChurchOn August 25, 2016, Baird’s Creek Presbyterian Church donated about 50 new water bottles for Radiation Oncology patients and two boxes full of items for the Chemotherapy Oncology room including adult coloring books, coloring pencils, puzzle books, etc.

From left to right in photo above: Pastor of Baird’s Creek Presbyterian Church, Keith Freeman; Church Member, Jinx Miller; Angie Shoemake; Holly Fletcher and Amy Isaacs

Angie Shoemake, Joanie Venza and Sandi Cassidy

From left to right in photo to left: Sandi Cassidy, Cathy Bloomberg from The Leukemia & Lymphoma Society, Adriane Lewis from Modern Subaru of Boone and Bryan Johnson from Modern Automotive

Ms. Opal Gragg and Dr. Flint Gray



In 2016, the Cancer Center’s Cancer Resource Alliance (CRA) Advisory Committee recommended that a small, albeit dedicated, group of individuals volunteer to form an Art Committee. They perform tasks such as taking inventory of current art and arranging displays throughout the Cancer Center. The members of the CRA, who volunteered to serve on the new Art Committee include: Beth Andrews, Bettie Bond, Sandi Cassidy, Julie Getty, Linda Nixon, Betty Mize, Mary Morgan and Sue Creech. As their initial project, these ladies created beautiful winter wonderland 3-D displays to decorate the infusion room – pictured left. In the future, the committee members will continue to inspire creativity and artistic displays to promote healing and reduce the stress of treatment.

Open Studio Support GroupDates of Service 9/9/14 - 9/30/16

In collaboration with Blue Ridge Expressive Arts, operated by Ms. Tyler Deal, Seby B. Jones Regional Cancer Center began offering weekly open studio support groups in September 2014. Through the generous support of the Cancer Resource Alliance, Cheap Joe’s Art Supplies and several community members this program was able to continue to grow during 2015 and through 2016. Each year has seen a significant increase in the amount of new participants and most importantly repeat participants that have built the groups into their schedules as they transition into survivorship as a means of support and connection while navigating the road to recovery.

SUMMARY: Seby B. Jones Regional Cancer Center began offering weekly open studio support groups in September of 2014. Through the generous support of the Cancer Resource Alliance, Cheap Joe's Art Supplies and several community members this program was able to continue to grow during 2015 and through 2016. Each year has seen a significant increase in the amount of new participants and most importantly repeat participants that have built the groups into their schedules as they transition into survivorship as a means of support and connection while navigating the road to thriving.

Unique Individuals

Total number of participants

Sept. 2014 - Dec. 2014 8 47

Jan. 2015 - Nov. 2015 15 128

Mar. 2016 - Sept. 2016 23 155

Monthly Totals 46 330

8 15 23 47

128 155

Sept. 14'- Dec. 14' Jan. 15' - Nov. 15' Mar. 16' - Sept. 16'

Unique Individuals Total Participants

Unique Individuals

Total number of participants

9/14 - 12/14 8 471/15 - 11/15 15 1283/16 - 9/16 23 155

Monthly Totals 46 330

New Art Committee

The SBJRCC is indebted to Ms. Anita Clemmer and the High Country Audubon Society who refill multiple bird feeders twice a week, in all kinds of weather, at the Cancer Center’s “back yard bird sanctuary.”

Special thanks to the Blue Ridge Garden Club for faithfully bringing flowers to the Cancer Center to make the lobbies more beautiful and for seasonally decorating, planting and caring for the Cancer Center’s “back yard” which hosts bird feeders, houses, seasonal potted plants and decorations. They maintain a healthy garden area for cancer patients to view daily from large, full-length picture windows in the infusion room.

The Blue Ridge Garden Club Committee includes:Kathleen CasciniDianne DoughertyJanice LaCapraSusan MillerDoris Pratchford, along with her bird club

Back Yard Bird Sanctuary

Emmie StallingsJoanie VenzaJudy WilliamsonSandy Wells

2016 | 17

New Initiatives

Cancer Center launches Rise Up: Your Path as a SurvivorBy Josh Jarman, Community Liaison

To enhance the continuum of care, Seby B. Jones Regional Cancer Center recently launched a new Survivorship Care program for its patients. In compliance with The Commission on Cancer’s accreditation requirements, the purpose of the program is to assist patients in transitioning after they have completed their cancer treatment.

Prior to treatment, each patient meets with Paul Young, RN, Oncology Nurse Navigator at Seby B. Jones Regional Cancer Center. Young understands that for the majority of patients, simply hearing the words “you have cancer” can have a devastating effect on a person’s emotional health. For this reason, The Cancer Center expanded its Navigation Team in 2013 to include a Social Resource Navigator, a Counseling Navigator and a Financial Navigator. Together, the Navigation Team works with the patient to detect and overcome barriers to treatment.

“Fortunately, thanks to advances in medicine and technology, more patients are surviving cancer today than ever before,” said Young. “Consequently, we don’t want our patients to finish their treatment with us only to fall through the cracks once they leave.”

Enter the recently developed Survivorship Program, led by oncology physician assistant, Barbara Dean. Pre-treatment, Dean will meet with each patient to review their upcoming treatment in detail. This meeting encompasses care for the whole patient, and is not just treatment oriented. Post treatment, Dean will see each patient to deliver a Survivorship Care Plan (SCP) if appropriate, as dictated by the Commission on Cancer. The SCP outlines their cancer characteristics, attending physicians, treatment process, persistent symptoms, potential long term effects, medications and follow-up care plan, which includes transitioning back to

their primary care provider. This visit also addresses prevention of new malignancies, discussion on nutrition, sleep, physical activity and lifestyle changes, like smoking cessation. It will help bridge a gap that had not previously been fully addressed for patients after treatment.

Similar to the Navigation Team’s initial assessment, Dean evaluates each patient’s psychosocial, physical and financial condition to determine if additional assistance is needed. Thanks to the comprehensive care available through Appalachian Regional Healthcare System, Dean can easily refer these patients to professional counseling, rehabilitation, lymphedema services, financial assistance, alternative medicine therapies and other treatments. Expectations for recovery from side effects from treatment will be reviewed and cancer recurrence fears, addressed.

“Evidence suggests that it usually takes one to two years for a cancer survivor to transition back to normal life, if that is even possible,” said Sandi Cassidy, Director of Oncology Services at Seby B. Jones Regional Cancer Center. “By adding the Survivorship Program, we hope to not only help our patients beat cancer, but transition safely back to a normalcy in their daily lives.”

Dean adds, “There’s a movement to treat a patient as a whole person, from start to completion, or throughout their course, however long that may be. It’s not just about choosing a treatment to battle cancer. It’s also about seeing the whole picture for our patients.”

The survivorship program, Rise Up: Your Path as a Survivor, launched on May 1, 2016 at the Seby B. Jones Regional Cancer Center.

Barbara Dean, PA-C


Cancer Registry ReportThe Cancer Program at Watauga Medical Center (WMC) is an accredited member of the Commission on Cancer (CoC). These programs are concerned with the full continuum of cancer from prevention through hospice and end-of-life care to survivorship and quality of life. CoC Accreditation is granted only to the facilities that have voluntarily committed to provide the best in cancer diagnosis and treatment, and are able to comply with established CoC standards. These standards are found in the Cancer Program Standards Manual: Ensuring Patient-Centered Care, 2016 edition, of which there are 12 eligibility requirements and 34 standards. Each Cancer Program must undergo a rigorous evaluation and review of its performance and compliance with the CoC standards. To maintain accreditation, facilities meet each standard yearly and undergo an on-site review every three years. The Cancer Center program has much to be proud of after its survey in September.

In 2016, the Cancer Committee approved two specific studies per Standard 4.7, Studies of Quality, in the CoC Standards Manual, to measure the quality of care and outcomes for cancer patients at WMC.

Study #1: Time lapse study for chemotherapy wait times: It seemed that there was a significant time lapse between the time patients leave the exam room and actually start their chemotherapy treatments. A time study was conducted to determine the time elapse from the end of the Medical Oncology physician visit to the time of chemotherapy start. There were 54 observations recorded from August to September 2016, where the average time lapse from the end of the physician visit until chemotherapy started was 40 minutes.

Quality Improvements for the Cancer Program for 2016 from Study #1 (Standard 4.8, Quality Improvements): • As a result of the Time Lapse Study for chemotherapy wait times, an improvement was made to reduce the

wait time for chemotherapy infusion patients. The physician visit and the chemotherapy visit will now be separated for patients traveling less than 30 minutes for treatment, thereby reducing patient wait times for chemotherapy infusion. Patients who travel more than 30 minutes will continue to have physician visits and scheduled chemotherapy visits on the same day.

Study #2: Communication between Medical Oncologists and Primary Care Physicians: Medical Oncology Providers were concerned that their dictated notes were not reaching the primary care providers for mutual patients, which can have a negative impact on continuity of patient care. In 2015, 12 random days were selected to review dictation of patient charts, and it was found that only 54 percent of those Medical Oncology notes were sent to the primary care physicians. To increase this rate, re-education was made available to transcriptionists, and reminders given to physicians to include fax numbers for the primary care physicians in the dictation notes. In 2016, 12 random days were selected to review dictation notes again and it was found that 81 percent of notes were now sent to primary care physicians, a substantial increase.

Quality Improvements for the Cancer Program for 2016 from Study #2 (Standard 4.8, Quality Improvements): • As a result of the Communication Study, the initial rate where the dictation notes went to primary care

physician was 54 percent in 2015, but after re-education, the rate jumped to 81 percent in 2016, and an improvement was made.

Other Quality Improvements for the Cancer Program for 2016 include (Standard 4.8, Quality Improvements):• A mid-level provider (Barbara Dean, PA-C), was added to the Cancer Center team, who is able to float to the

infusion room when needed to manage acute patient problems. This improvement has increased the safety and quality of care for infusion room patients.

• A multidisciplinary Clinical Advisory Committee was established which provides education opportunities to improve clinical nursing staff competency.

• Collaboration between Ashe Memorial Hospital and WMC was established in order to share infusion room services, thereby addressing one of our barriers to care, which is transportation, for our patients.

Amy Freeman, CTR

Amy Freeman, CTR

2016 | 19

Top 5 sites -‐ Local, State & National ComparisonBreast, Lung, Colon/Rectum, Prostate & Urinary Bladder2015 Top 5 Sites -‐ Local, State & National Comparison

SBJRCC* NC** US***Breast 22.40% 14.38% 14.63%Lung & Bronchus 13.60% 14.45% 13.31%Colon & Rectum 10.20% 7.86% 7.98%Prostate 7.50% 11.00% 10.73%Urinary Bladder 5.40% 4.18% 4.56%

SBJRCC* NC** US***Breast 87 7830 246,660Lung & Bronchus 53 7870 224,390Colon & Rectum 40 4280 134,490Prostate 29 5990 180,890Urinary Bladder 21 2280 76,960

* Seby B. Jones Regional Cancer Center Registry -‐ 2015 Analytic Cases** American Cancer Society estimated new 2016 cancer cases in NC: from 2016 Cancer Facts & Figures***American Cancer Society estimated new 2016 cancer cases in US: from 2016 Cancer Facts & Figures

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

SBJRCC* NC** US***

Breast

Lung & Bronchus

Colon & Rectum

Prostate

Urinary Bladder





0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

SBJRCC* NC** US***

Breast

Lung & Bronchus

Colon & Rectum

Prostate

Urinary Bladder





0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

SBJRCC* NC** US***

Breast

Lung & Bronchus

Colon & Rectum

Prostate

Urinary Bladder





0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

SBJRCC* NC** US***

Breast

Lung & Bronchus

Colon & Rectum

Prostate

Urinary Bladder





0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

SBJRCC* NC** US***

Breast

Lung & Bronchus

Colon & Rectum

Prostate

Urinary Bladder





0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

SBJRCC* NC** US***

Breast

Lung & Bronchus

Colon & Rectum

Prostate

Urinary Bladder

Top 5 Sites - Local, State & National ComparisonBreast, Lung, Colon/Rectum, Prostate & Urinary Bladder

2015 Top 5 Sites - Local, State & National Comparison

* Seby B. Jones Regional Cancer Center Registry - 2015 Analytic Cases** American Cancer Society estimated new 2016 cancer cases in NC: from 2016 Cancer Facts & Figures***American Cancer Society estimated new 2016 cancer cases in US: from 2016 Cancer Facts & Figures

SBJRCC* NC** US*** Breast 22.40% 14.38% 14.63% Lung & Bronchus 13.60% 14.45% 13.31% Colon & Rectum 10.20% 7.86% 7.98% Prostate 7.50% 11.00% 10.73% Urinary Bladder 5.40% 4.18% 4.56%


Perc

ent o

f cas

es

25.00%

20.00%

15.00%

10.00%

5.00%

0.00%


Breast Cancer Comparison Report

Lung Cancer Comparison Report

Colorectal Cancer Comparison Report

2016 | 21

Male Female Analytic Alive Expired Stage 0 Stage I Stage II Stage III Stage IVStage

unknown or N/A

12 3 15 11 4 1 2 2 2 8 04 0 4 2 2 0 0 0 1 3 02 1 3 3 0 0 1 0 1 1 01 0 1 1 0 0 0 0 0 1 02 1 3 2 1 0 1 1 0 1 01 0 1 1 0 0 0 0 0 1 02 1 3 2 1 1 0 1 0 1 045 22 67 43 24 0 16 11 13 24 34 0 4 2 2 0 0 0 0 4 04 0 4 1 3 0 0 1 0 1 20 3 3 3 0 0 1 1 1 0 019 8 27 17 10 0 12 5 4 6 04 2 6 3 3 0 2 2 1 1 00 2 2 2 0 0 1 0 0 1 04 1 5 3 2 0 3 0 2 0 02 1 3 3 0 0 2 1 0 0 02 0 2 1 1 0 2 0 0 0 02 0 2 2 0 0 0 1 0 1 04 1 5 2 3 0 2 0 1 2 01 1 2 1 1 0 0 1 0 1 09 4 13 11 2 0 2 3 5 2 11 0 1 1 0 0 0 1 0 0 08 4 12 10 2 0 2 2 5 2 11 1 2 2 0 0 0 0 2 0 05 1 6 3 3 0 0 0 1 5 03 5 8 4 4 0 1 1 0 6 040 17 57 26 31 0 10 1 23 23 01 0 1 1 0 0 0 0 1 0 02 1 3 3 0 0 1 0 1 1 037 16 53 22 31 0 9 1 21 22 02 0 2 1 1 0 0 1 0 1 02 0 2 1 1 0 0 1 0 1 01 1 2 1 1 0 1 0 1 0 01 1 2 1 1 0 1 0 1 0 09 4 13 10 3 1 6 3 2 1 08 3 11 8 3 1 6 2 1 1 01 1 2 2 0 0 0 1 1 0 00 87 87 85 2 13 44 25 5 0 00 87 87 85 2 13 44 25 5 0 00 11 11 8 3 0 3 2 2 2 20 1 1 0 1 0 0 0 0 1 00 4 4 4 0 0 2 1 0 0 10 4 4 3 1 0 1 0 2 1 00 1 1 1 0 0 0 1 0 0 00 1 1 0 1 0 0 0 0 0 131 0 31 29 2 0 9 15 3 4 029 0 29 27 2 0 8 14 3 4 01 0 1 1 0 0 1 0 0 0 01 0 1 1 0 0 0 1 0 0 021 2 23 21 2 14 5 2 0 2 020 1 21 19 2 14 4 2 0 1 01 1 2 2 0 0 1 0 0 1 03 7 10 6 4 0 0 0 0 0 102 3 5 1 4 0 0 0 0 0 51 4 5 5 0 0 0 0 0 0 52 8 10 10 0 0 7 0 1 1 12 7 9 9 0 0 7 0 1 1 00 1 1 1 0 0 0 0 0 0 14 7 11 7 4 0 2 2 4 3 01 1 2 2 0 0 0 1 1 0 03 6 9 5 4 0 2 1 3 3 02 5 7 3 4 0 2 1 3 1 01 1 2 2 0 0 0 0 0 2 05 4 9 7 2 0 0 0 0 0 95 4 9 7 2 0 0 0 0 0 99 6 15 11 4 0 0 0 0 0 156 5 11 8 3 0 0 0 0 0 115 5 10 7 3 0 0 0 0 0 101 0 1 1 0 0 0 0 0 0 13 1 4 3 1 0 0 0 0 0 42 0 2 2 0 0 0 0 0 0 21 1 2 1 1 0 0 0 0 0 21 0 1 1 0 0 0 0 1 0 01 0 1 1 0 0 0 0 1 0 012 13 25 20 5 0 0 0 0 0 2512 13 25 20 5 0 0 0 0 0 25197 192 389 297 92 29 105 64 57 69 65

Tongue 4 (1.0%)ORAL CAVITY & PHARYNX 15 (3.9%)

Primary Site Total (%)

Gum & Other Mouth 3 (0.8%)Floor of Mouth 1 (0.3%)Salivary Glands 3 (0.8%)

DIGESTIVE SYSTEM 67 (17.2%)Tonsil 3 (0.8%)Nasopharynx 1 (0.3%)

Small Intestine 3 (0.8%)Stomach 4 (1.0%)Esophagus 4 (1.0%)

Appendix 2Cecum 6

Colon Excluding Rectum 27 (6.9%)

Transverse Colon 2Hepatic Flexure 3Ascending Colon 5

Large Intestine, NOS 2Sigmoid Colon 5Descending Colon 2

Rectum 12Rectosigmoid Junction 1

Rectum & Rectosigmoid 13 (3.3%)

Pancreas 8 (2.1%)Liver & Intrahepatic Bile Duct 6 (1.5%)Anus, Anal Canal & Anorectum 2 (0.5%)

Larynx 3 (0.8%)Nose, Nasal Cavity & Middle Ear 1 (0.3%)RESPIRATORY SYSTEM 57 (14.7%)

Bones & Joints 2 (0.5%)BONES & JOINTS 2 (0.5%)Lung & Bronchus 53 (13.6%)

SKIN EXCLUDING BASAL & SQUAMOUS13 (3.3%)Soft Tissue (including Heart) 2 (0.5%)SOFT TISSUE 2 (0.5%)

BREAST 87 (22.4%)Other Non-Epithelial Skin 2 (0.5%)Melanoma -- Skin 11 (2.8%)

Cervix Uteri 1 (0.3%)FEMALE GENITAL SYSTEM 11 (2.8%)Breast 87 (22.4%)

Vagina 1 (0.3%)Ovary 4 (1.0%)Corpus & Uterus, NOS 4 (1.0%)

Prostate 29 (7.5%)MALE GENITAL SYSTEM 31 (8.0%)Vulva 1 (0.3%)

URINARY SYSTEM 23 (5.9%)Other Male Genital Organs 1 (0.3%)Testis 1 (0.3%)

BRAIN & OTHER NERVOUS SYSTEM10 (2.6%)Kidney & Renal Pelvis 2 (0.5%)Urinary Bladder 21 (5.4%)

ENDOCRINE SYSTEM 10 (2.6%)Cranial Nerves Other Nervous System 5 (1.3%)Brain 5 (1.3%)

LYMPHOMA 11 (2.8%)Other Endocrine including Thymus 1 (0.3%)Thyroid 9 (2.3%)

NHL - Nodal 7Non-Hodgkin Lymphoma 9 (2.3%)Hodgkin Lymphoma 2 (0.5%)

Myeloma 9 (2.3%)MYELOMA 9 (2.3%)

NHL - Extranodal 2

Chronic Lymphocytic Leukemia 10Lymphocytic Leukemia 11 (2.8%)LEUKEMIA 15 (3.9%)

Acute Myeloid Leukemia 2Myeloid & Monocytic Leukemia 4 (1.0%)

Other Lymphocytic Leukemia 1

Mesothelioma 1 (0.3%)MESOTHELIOMA 1 (0.3%)

Chronic Myeloid Leukemia 2

Total 389Miscellaneous 25 (6.4%)MISCELLANEOUS 25 (6.4%)

Annual Report of Cancer Registry DataSeby B. Jones Regional Cancer Center at Watauga Medical Center

2015 Summary by Body System, Gender, Class, Status and AJCC Stage Report


Top Sites, Grouped by Gender

0

20

40

60

80

100

120

2010 2011 2012 2013 2014 2015 Breast 68 94 91 83 110 87

Lung & Bronchus 15 26 22 30 25 16

Colon & Rectum 11 12 24 11 14 12

Non-‐Hodgkin Lymphoma 10 9 9 7 10 6

Thyroid 11 6 7 7 10 7

Uterine 5 7 7 7 10 4

Leukemia 8 4 7 11 7 6

0

5

10

15

20

25

30

35

40

2010 2011 2012 2013 2014 2015 Prostate 22 28 12 14 17 29

Lung & Bronchus 26 31 31 28 29 37

Non-‐Hodgkin Lymphoma 16 9 8 9 12 3

Colon & Rectum 11 15 13 16 15 28

Melanoma of the skin 8 6 8 9 14 8

Bladder 12 19 12 13 14 20

Oral Cavity & Pharynx 8 8 5 5 12 12

Num

ber o

f cas

esN

umbe

r of c

ases

Top 7 Cancer Sites for Women at SBJRCC 2010-2015

Top 7 Cancer Sites for Men at SBJRCC 2010-2015

WATAUGA MEDICAL CENTERSexFilter(s): Quick Filter: Year:1ST CONTACT YEAR 2015-2015 AND Class of Case: A AND ( CaseStatFlag = `C` ):

Sex(1) Male(2) FemaleOtherTotal

Page 1

(1) Male

(2) Female

Other

2015 Newly Diagnosed Cancers by Gender

1081095724

40 - 49 50 - 59 60 - 69 70 - 79 80 - 89 Other

Male Female

1

2

3

4

5

6

Male (197)

Female (192)51%49%

2016 | 23

2016 Cancer Cases presented by SiteBreast (116) 116Colon/Rectal (21) 21Lung (31) 31Melanoma (8) 8Thyroid (2) 2All Other sites (39) 39Lymphoma (8) 8

Breast (116)

Colon/Rectal (21)

Lung (31)

Melanoma (8)

Thyroid (2)

All Other sites (39)

Lymphoma (8)

Seby B. Jones Regional Cancer Center, Cancer Registry Data

1081095724

40 - 49 50 - 59 60 - 69 70 - 79 80 - 89 Other

Male Female

1

2

3

4

5

6

40 - 49 (27)

50 - 59 (64)

60 - 69 (108)

70 - 79 (109)

80 - 89 (57)

Other (24)

2016 Age of Diagnosis of all Cancer Cases

28% 28%

16%

7%6%

15%

2016 Cancer Cases Presented by Site

2016 Seby B. Jones Regional Cancer Center, Cancer Conference/Tumor Board SummaryDates of Service 1/1/16 - 12/14/16

49 Conferences were held225 Cases presented

2016 Cancer Cases presented by SiteBreast (116) 116Colon/Rectal (21) 21Lung (31) 31Melanoma (8) 8Thyroid (2) 2All Other sites (39) 39Lymphoma (8) 8

Breast (116)

Colon/Rectal (21)

Lung (31)

Melanoma (8)

Thyroid (2)


Lymphoma (8)

Breast (116)

Colon/Rectal (21)

Lung (31)

Melanoma (8)

Thyroid (2)


Lymphoma (8)

3%52%

4%

14%

17%

1%

9%


Quality & Liaison Annual Report

It is a privilege to serve as the Cancer Liaison physician for our community cancer program. We continue to strive for excellence and improve our program to offer our cancer patients compassionate, quality care.

This year we received our evaluation for continued accreditation as a Community Cancer Center through the American College of Surgeons - Commission on Cancer, which is the national organization reviewing hospitals for the highest level quality of cancer care in the United States. For this scheduled review, which occurs every three years we received very positive feedback from our reviewer and benefited from the collaboration from an outside review. We will use the suggestions from the American College of Surgeons - Commission on Cancer to develop further quality studies and programmatic goals, which will continue to enhance our cancer center.

We use the Rapid Quality Reporting System to monitor timely and appropriate care under research-based guidelines. For the data points reviewed regarding comprehensive pathology reporting and appropriate treatment for different stages of breast and colon cancer, we received the highest marks. We will continue to use this tool for monitoring effective treatment strategies with real-time data.

We continue to streamline two important programs in our community, which started at the end of 2015. The first was modifying appropriately the Thrive program to achieve maximum and lasting results in weight loss. This is a multidisciplinary approach to weight loss and headed by the Exercise Specialists at the Paul H. Broyhill Wellness Center. This has been a highly successful program for people in our community to lose weight in an encouraging, monitored environment with an approach centered on nutrition, exercise, and well-being. We hope to expand this program in the future to allow more participants. The benefit of having a healthy weight and mindset is well documented in reducing the risk of developing multiple different cancers, including breast and colon cancers.

The second program was to continue to smooth the process of timely and state-of-the-art screening and workup of breast abnormalities through The Wilma Redmond Breast Center. We are very fortunate to have 3-D mammograms or tomosynthesis. This updated imaging has been proven to increase the detection rate of invasive breast cancer and reduce the call back rate for false findings. Appalachian Regional Healthcare System is providing 3-D mammograms for all patients for improved breast imaging at the Boone location. We also have the benefit of a Breast Navigator, Gloria Payne, to monitor abnormal breast imaging reports, relay this information to patients and ensure appropriate next steps are taken. The radiologists continue to provide quick turn-around rates for reading mammograms, which is faster than the national average.

We serve a large rural community with our cancer program, and we are honored to be able to provide the care, imaging, and treatment here at the level of accreditation with outstanding marks. We will continue, however, to strive for improvement and keep current with the latest technology, research and treatment for our patients.

Dr. Anne-Corinne BeaverAnne-Corinne Beaver, MD, FACSSurgeon, Cancer Liaison Physician

Anne-Corinne Beaver, MD

2016 | 25

Clinical Research Annual Report

The Oncology Clinical Research Department under the direction of Dr. Anna Sobol strives to offer opportunities for our mountain community to participate in research. Having studies open and accruing enables a greater number of High Country residents to participate in research.

Dr. Anna Sobol is the Principal Investigator for all currently open studies. Dr. Flint Gray is the Co-Principal Investigator in University of North Carolina-Chapel Hill (UNC-CH) studies. Marjorie Hrozencik RN, BSN, OCN, CCRP serves as Clinical Research Coordinator.

Seby B. Jones Regional Cancer Center (SBJRCC) is a research affiliate location for the University of North Carolina at Chapel Hill. Currently there are two trials that we are partnering with UNC-CH to conduct. Carolina Senior is a registry study recruiting patients over the age of 65 that gathers information about functional age. The second being an interventional study, S-PACT (Senior Physical Activity after Chemotherapy) that is temporarily on hold for recruitment.

In 2014, the first industry-sponsored trial opened at SBJRCC. REVEAL is a prospective, non-interventional study of disease progression and treatment of patients with polycythemia vera being treated in United States academic or community clinical practices. REVEAL closed to accrual in June 2016, with 13 individuals enrolled at our site. Those enrolled remain active in the observational study for up to 36 months.

Patients are also referred off site to be evaluated for clinical trial participation. There are five patients this year that have participated in a clinical trial.

January 1, 2016 – November 28, 2016 the overall accrual into all trials both on and off site were 21. Commission on Cancer (CoC) has set the minimum required percentage for clinical trial enrollment in a Community Cancer Program at 2 percent of the number of analytic accessions. Our clinical trial program is at 5.4 percent exceeding the minimum CoC accrual standard.

Marjorie Hrozencik successfully completed all the requirements set forth by the Society of Clinical Research Associates and was granted the designation of Certified Clinical Research Professional (CCRP) November 1, 2016. The certification is an internationally accepted standard of education, knowledge and experience by which research professionals are recognized within the clinical research community.

Marjorie Hrozencik RN, BSN, OCN, CCRP

Marjorie Hrozencik, RN, BSN, OCN, CCRP


Vital Stats

Social Work Data SummaryDates of Service 10/1/15 - 9/30/16

Psychosocial Assessments CompletedChemotherapyRadiationBoth

Patient Care Support Folders

Advanced DirectivesHealth Care Power of AttorneyLiving WillFive WishesPOA

Financial AssistanceAsheAveryWataugaSurrounding

Patients received some type of assistance

Breast & Cervical ProgramDates of Service 7/1/15 - 6/30/16

Total patients served 62

The North Carolina Breast & Cervical Cancer Control Program (NC BCCCP) provides free or low cost breast and cervical cancer screenings and follow-up to eligible women in North Carolina. The Appalachian District Health Department provides these services to women in Watauga County. Toe River Health District provides these services to women in Avery County.

27688

13949

257

361515

51

$65,535.38$13,659.20

$9,926.11$27,665.41$14,284.66

181

Nurse Navigation Data SummaryDates of Service 10/1/15 - 9/30/16

New Patients Navigated 243

Disease sitesBreast 78 Gyn 9Skin 8 Malignant Heme 28Thoracic 52 GU 16GI 20 Brain 5Head & Neck 12 Unknown Primary 2

Payer ClassesMedicare 136 Commercial 75Medicaid 20 Uninsured 12

Top Barriers to CareKnowledge deficit regarding diagnosis and treatment, Financial concerns, Transportation difficulties, Fatigue

Total Referrals Made 753Social Worker 242 Pain Clinic 15Dietitian 71 Prescription Assist. 42Financial Navigator 240 Clinical Trials 5PT/OT/SP Therapy 47 Home Health/Hospice 18Behavioral Health 19 Second Opinion 9Transfer Care 45

Behavioral Health Colocation SummaryDates of Service 10/1/15 - 9/30/16

Total Initial Assessments Conducted 36Follow-up Sessions Conducted 38Informal Sessions 16Referrals to Psychiatry 1

THRIVE Oncology Data SummaryDates of Service 10/1/15 - 9/30/16

Total Participants 34Total Visits 851Total Restarts 7Graduation Rate 40.5%6 Minute Walk Test (6MWT) 21.2% Increase

2016 | 27

Three Year Strategic Plan

2016 Strategies Accomplished • Genetic Counseling on-site in collaboration with Levine Cancer Institute• Collaborative with Ashe Memorial Hospital to open their infusion room services• Implemented the Cancer Center Survivorship Program – Rise Up: Your Path as a

Survivor

2017• Complete the 2016 planned renovations for the Radiation Oncology Department• On board a new Radiation Oncology physician• Install a GE 16-slice CT w/SIMS planning software• Launch Lung Cancer Screening Program• Advance the use of trained Lay Navigation members of the Oncology Team to enhance services to

patients (this is a grant funded initiative with the UNC Lineberger Cancer Center at Chapel Hill, NC)

2018 • Work with Diagnostic Imaging, obtain Accreditation for the Breast Center of Excellence• Build “on site” access services for oncology pharmacy administration• Work with Corporate Communications to thoroughly understand social media networks that can

assist patients in support group like models through networking without geographical limitations• Work with industry leaders, thoroughly understand the future and impact to the Oncology Service

Line OP Services for the increased use of oral chemo-bio therapy treatments and appropriately monitoring the patient while at home

2019• Commission on Cancer three-year Cancer Program Survey• Implement Stereo Body Radiation Therapy (SBRT) • Work with industry leaders, thoroughly understand multi-functional radiology and using MRI

guidance to deliver gene therapy; for example in brain tumors• Work with industry leaders, thoroughly understand Pain Management with new technologies like

Quell, a wearable technology with intensive nerve stimulation to manage chronic pain

Sandra L. Cassidy, MHASystem Director

Oncology Service Line

Medical Oncology(828) 262-4332 • Fax: (828) 265-5514Located on the campus of Watauga Medical Center338 Deerfield Road • Boone, NC 28607Monday - Friday 8:00 am - 5:00 pmSeby B. Jones Regional Cencer Center Oncologists also provide services at:Ashe Oncology Cancer Center 200 Hospital Avenue • Jefferson, NC 28640Wednesday 9:00 am - 12:00 pmGrandfather Specialty Clinic436 Hospital Drive, Suite 210 • Linville, NC 28646Tuesday 1:30 pm - 4:30 pm

Radiation Oncology(828) 262-4342 • Fax: (828) 262-4414Located on the campus of Watauga Medical Center338 Deerfield Road • Boone, NC 28607Monday - Friday 8:00 am - 5:00 pm

Infusion Center (non-oncology)(828) 262-4332 • Fax: (828) 265-5514Located on the campus of Watauga Medical Center338 Deerfield Road • Boone, NC 28607Monday - Friday 8:00 am - 5:00 pm

apprhs.org/cancer

Seby B. Jones Regional Cancer Center is located on the Watauga Medical Center campus. Watauga Medical Center is a member of Appalachian Regional Healthcare System.

Seby B. Jones Regional Cancer Center

Documents

Transcript of Seby B. Jones Regional Cancer Center