Cancer Center Results

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Cancer Center
2400 E 17th St
Columbus , IN

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Coordinated Treatment, Superior Results

Our Cancer team understands that a well coordinated treatment plan is beneficial for our patients.

Below are some examples of how our Cancer Center continues to strive for top quality results. 

   2017 Results

Lung Cancer Screening and the Efforts of Columbus Regional Hospital’s Multidisciplinary Lung Nodule Review Board

Lung Cancer is by far the leading cause of cancer deaths in Indiana and the United States, at over 150,000 deaths per year related to lung cancer.  The team of cancer specialists at CRH is continually seeking new treatments and technologies to fight all cancers and improve cancer outcomes. 

Early detection is vital for best outcomes in the treatment of lung cancer.  Patients with heavy smoking histories should be informed that studies have shown that annual low-dose computed tomography (CT) screenings can reduce lung cancer mortality by 20% and even reduce all-cause mortality by 7%. The 2011 major study of heavy smokers and lung screening, called the National Lung Screening Trial, compared screening for lung cancer using lung CT scans and chest x-rays.  This was the first study to show that lung cancer screening may save lives by showing that lung CT scan for screening lowered the risk of dying from lung cancer by 20% among screened current and former heavy smokers.  Low-dose CT lung screening can result in 3 less cancer deaths per 1000 persons at risk (age, smoking history) compared to chest x-ray screening for the same patient group. For comparison, this is a larger reduction in cancer deaths than occurs by doing mammograms for breast cancer screening.

The dedicated team of cancer professionals and CRH leadership partnered together in early 2017 to increase the public awareness of the need for cancer screening and went to local primary care physician’s offices to help get more patients screened by increasing the awareness of the lung cancer screening benefit and the ability of CRH to perform such studies. Our low-dose CT scans ensures minimal radiation exposure during the screening study and all patients that are screened are aggressively counseled on smoking cessation and provided resources and contact for smoking cessation efforts if elected. Cigarette smoking is the number one cause of lung cancer and is linked to at least 80% of lung cancers.

A short-term $10 promotional price and patient/physician education was provided to offer low-dose CT lung screening to all patients ages 55-77 with a 30 pack/year smoking history who are current smokers or quit in the last 15 years. The NCCN (National Comprehensive Cancer Network) current guidelines for high-risk patients to screen also gives consideration for patients ages 50 and older with greater than 20 pack /year smoking history. 

Frequently Asked Questions About Lung Cancer Screening

(Answers from the Multidisciplinary team, Drs. John Cox, Kevin McMullen, Deep Sharma, David Hart and Gregory Dedinski)

Q- What is the goal of lung cancer screening?

A-To save lives! If we wait until a patient develops symptoms we are typically diagnosing patients with more advanced cancer and potentially less curative treatment options. At CRH, we are able to meet every Tuesday morning as a dedicated team of Radiologists, Pulmonologists, Thoracic Surgeons, Medical and Radiation Oncologists to review worrisome lung screening studies and aid patients and their primary care physicians in the need to navigate towards improved pulmonary health.

Q- Who should get a low-dose CT lung screening exam?

A-Low Dose Lung Screening CT scans are recommended for people with high-risk findings as per the two risk groupings above.  If you feel that you are at high risk, please call our screening number at (812) 669-1628 and a lung cancer expert will talk through your unique case with you to see if screening is right for you. 

Q- How is the exam performed?

A-The low-dose CT lung screening is very straightforward.  It does not require IV contrast, no medications are given and no needles are used.  You can eat before and after the exam.  The test does require a person to hold their breath for at least 6 seconds while the chest scan is being taken.

Q- Are there any risks to low-dose CT lung screening?

A-There are several risks and potential limitations of low-dose CT lung screening. 

  1. Radiation exposure: By using special techniques, the amount of radiation in low-dose CT lung screening is small—about the same amount a person would receive from a screening mammogram. Your doctor and the screening team at CRH have determined that the benefits of screening outweigh the risks of being exposed to the small amount of radiation from this scan.
  2. False negatives:  No screening test is perfect. Lower radiation doses, lack of IV contrast or other factors could lead to inability to identify a medical condition, including cancer, on a low-dose CT lung screening study.  This is one of the reasons that patients who are high risks are followed over time, at least annually, to ascertain that if a cancer were to develop that it would be detected as early as possible.
  3. False positive/additional testing: Further testing and work-up may be needed to more completely evaluate a patient’s scan.  All patients who have a low-dose CT scan are reviewed carefully by a radiologist and assigned a lung-RADS score (one to four, with four being more worrisome) and recommendation for next steps.  Patients with lung-RADS scores of 3-4 are evaluated by the weekly meeting of a multidisciplinary lung nodule review board which may assign further recommendations.  With any testing, anxiety and worry can be increased if additional testing or further study is needed. No further testing will be ordered or recommended without alerting your primary care physician or getting your permission.  Occasionally, patients need a procedure, such as a biopsy, that can have potential side effect or could need a different radiology investigation which could give more radiation.  In a small percentage of cases, the screening study may capture an area of clinical question outside or next to the lungs (including kidneys, adrenal glands, liver, thyroid, etc.) and this may require further study.  Your health care provider will be notified of this by a member of our multidisciplinary lung nodule review board.

Q- What are the goals of CRH and the lung multidisciplinary nodule review board

A-To assist our community to leading more high-risk smokers to the path of smoking cessation and using the lung screening program to assist them in ascertaining their lung health through the years ahead. We strongly want to spread the word on the complete thoracic care program we offer that is truly unique in the state of Indiana.

Columbus Regional Cancer Center Outcomes

In 2017 (1/1/2017 through 09/30/2017), a total of 419 patients have been screened with low dose CT lung screening studies.  A total of six cancers have been identified on these initial screening scans. Four patients were identified with Stage I disease, one patient with stage II disease and one patient with stage III disease. 

Please see how we can partner with your long-term health moving forward if you or a loved-one meets the criteria of high-risk lung screening noted above.  Finding abnormalities earlier is important and we are ready to be your partner in pulmonary health going forward.

Thanks,

John A. Cox, MD

In compliance with Commission on Cancer (COC) std 4.2, Columbus Regional Hospital Cancer Center, in coordination with our community dermatologists, invited the community to participate in the now annual Free Skin Cancer Screening event. This was held on 05/12/16 in the Cancer Center with special thanks to Dr. Eduardo Rivera and Dr. Michael Sheehan. Screening was held with targeted goal of decreasing the number of patients presenting with late stage skin cancers and promoting earlier access to specialist care to potential patients who may not be getting regular skin assessments in our medical community and may not have otherwise had ease of access to board certified dermatologists.

Sixty-one patients were evaluated in the after-clinic event. Twenty-six patients were referred for further evaluation ( 42.6% of participants) which prompted the diagnosis and treatment of 7 cancerous or pre-cancerous skin lesions. The CRH COC leadership was happy to partner with this population during the screening program and creating a process for follow-up on positive findings and partnership with our medical community.

CRH Cancer Center is also happy to announce the addition of high-dose rate (HDR) skin surface brachytherapy treatment at our cancer center. In 2016, CRH began utilizing the Nucletron microSelectron® Digital Brachytherapy system for the treatment of skin, breast, prostate, advanced lung and gynecologic malignancies. This new technology significantly expands the radiation cancer treatment options available to our patients and the ability to get cutting edge care closer to home.

Basal cell and squamous cell carcinoma are the most common skin cancers, developing most often on sun-exposed body regions. These non-melanoma skin cancers can be treated with local excision or Moh's surgery as primary management. Radiation therapy for patients with difficult surgical risks such as increased bleeding factors, poor healing characteristics, multiple prior excisions or poor baseline performance status issues can be candidates for upfront initial curative radiation treatment or receive radiation as a part of the needed follow-up care after resections such as Moh's surgeries with adverse pathologic findings or in recurrent cancer situations. Brachytherapy offers patients a treatment option which is much shorter and much more comfortable than conventional external beam based radiation treatments. HDR brachytherapy provides good cosmetic results and is typically delivered in as few as six to ten treatments.

Dr. John A. Cox

The Commission on Cancer has developed a tool, the Rapid Quality Reporting System (RQRS), that enables accredited cancer center programs to report data on patients, to provide hospital notification of treatment expectations, and to show a hospital its year-to-date results relative to other similar hospitals in the area, as well as to other hospitals on a national level. The objective of the Rapid Quality Reporting System is to promote and facilitate evidence-based cancer care at Commission on Cancer accredited cancer programs. Participation in this program is voluntary. The RQRS serves to assess compliance with four measures for breast and colon cancers and one quality improvement measure for colon cancers in real clinical settings. The evidence is collected by the cancer registrar and presented in a graphic format that is very easy to understand.

The first three measures relate to breast cancer. The first measure is BCS (breast conserving surgery): radiation therapy is administered within one year of diagnosis for women under the age of 70 receiving breast conserving surgery for breast cancer. Columbus Regional Hospital has received 100% compliance on this measure.

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The second measure is MAC (multi-agent chemotherapy): combination chemotherapy is considered or administered within 4 months of diagnosis for women under 70 with hormone receptor negative breast cancer. Columbus Regional Hospital has received 100% compliance on this measure.

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The third measure is HT (hormone therapy): tamoxifen or aromatase inhibitors are considered or administered within one year of diagnosis for women with hormone receptor positive breast cancer. Once again, CRH has received 100% compliance on this measure.

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The next set of measures is related to colon cancer. The first measure is ACT (adjuvant chemo-therapy): adjuvant chemotherapy is considered or administered within 4 months of diagnosis of patients under the age of 80 with lymph node positive colon cancer. CRH has received 100% compliance on this measure.

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The second measure is related to 12 RLN (regional lymph nodes): at least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer. CRH has received 100% compliance on this measure.

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Tremendous effort was put into achieving these scores for the entire hospital. It has produced fantastic results that will continue to help provide the best care possible for the patients who have cancer and undergoing treatment at Columbus Regional Hospital. The cancer committee will continue to monitor these measures and continue to meet or exceed the expectations of the Commission on Cancer with respect to these measures.

Dr. Rahul N. Dewan

Breast Recommendation for Biopsy to Initial Treatment

In the treatment of breast cancer, studies show that it is essential for best outcomes that the patient see all of the recommended specialists on the journey through treatment in a timely manner. This requires a detailed process for timely referrals and appointments. Studies show that once a person has a mammogram that shows the need for a biopsy, the patient will have a superior outcome if they receive initial treatment within 42 days.

When a person has a mammogram and the physician says they need a biopsy, the clock starts ticking. Will the person see all the required specialists? Will the initial treatment begin within 42 days? The Breast Health Center and Cancer Center wanted to be sure that the pathway to the needed treatment was smooth and timely.

Our study reviewed the following process points:

  • Mammogram with recommendation for biopsy
  • Initial biopsy
  • Surgical consultation
  • Initial treatment

We studied this pathway and found that at CRH, we consistently provide initial treatment within 42 days.

The office of Southern Indiana Surgery has streamlined the evaluation process prior to IV port placement for chemotherapy. In most cases the SIS Nurse Practitioner can see the patient within 2-3 days of the call for appointment, and ports can typically be placed within a week.

To ensure that our patients receive the timely care that is associated with the best outcomes, our team is reviewing options for same day breast biopsies. This would further decrease the time between the recommendation of the biopsy and the actual biopsy; in some cases on the same day. The Cancer Center, the Breast Health Center, the surgeons groups, the radiologist groups, and quality management are proud to provide cancer care in time for the very best results.

Middle-aged couple on picnic blanket blowing bubbles together

$25 Lung Screening

Give the gift of health and peace of mind to yourself or a loved one so your family has many more years of special memories. Fast and painless, a low dose CT lung cancer screening can help detect potential signs of lung cancer earlier when it is easier to treat.

Learn more

Lung Nodule Review Board

Cancer Center physician John Cox MD
John Cox, MD
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20160623 Greg Dedinsky MD 314x
Gregory Dedinsky, MD
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David Hart MD
David Hart, MD
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Stephen Matthews, MD
Stephen Matthews, MD
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Cancer Center doctor Kevin McMullen MD
Kevin McMullen, MD
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Dr. Deepankar Sharma, MD
Deep Sharma, MD
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Cancer Center doctor Stephanie Wagner MD
Stephanie Wagner, MD
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Dawn Stidham, NP
Dawn Stidham, NP
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Sarah Abel
Sarah Abel

The Footprint of Therapy


Cancer Center oncologist Kevin McMullen, MD, discusses the advanced cancer treatment options available at Columbus Regional Health and the importance these tools play in survivorship. "From the time the patient first walks in the door, we need to be thinking about that patient as a cancer survivor," he said, "and we need to be thinking about the footprint of the therapy we leave behind."

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