Oncology Annual Report

2010

Summary

Breast cancer remains the most common cancer affecting women. Every year approximately 250,000 women are diagnosed with breast cancer in the United States. It is the second highest cause of cancer related mortality in women. We have, however, witnessed significant changes in the presentation, diagnosis and management of this disease.

William Stewart Halsted who is known as the father of breast surgery introduced his revolutionary Radical Mastectomy some 118 years ago. He brought some degree of hope to women affected by this disease which was one of the most dreadful illnesses at that time. There was no hope of survival for the unfortunate women who fell victims to it. In 1907 Halsted reported 36% survivors among the affected women under his care. As the surgical techniques improved, there were more aggressive and bolder pioneer surgeons who even proposed more radical approaches in treating breast cancer such as introduction of super radical mastectomy by Dr. Owen Wangsteen in 1949 and extended radical mastectomy by Dr. Jerome Urban in 1952. The morbidity increased but the survival did not improve enough to justify these extended radical mastectomies of the mid-1990s. It took about three quarters of century from Halsted’s radical mastectomy until breast cancer surgery was modified to a less aggressive procedure namely modified radical mastectomy with much less morbidity and interestingly better survival rates. Since then, the management of breast cancer has improved by leaps and bounds. Pressure by women activists and advocacy groups since 1970s resulted in increased public awareness, legislative actions and more funding for breast cancer which all contributed in revolutionizing breast cancer care.

As the multidisciplinary approach to breast cancer management improved, more limited surgery became norm in dealing with earlier stages of breast cancer. Earlier detection, improved neoadjuvant and adjuvant therapies as well as more advanced radiation therapy techniques have made it possible for affected women not only to have superior survival chances but also a great number of them are able to preserve their breasts.

New technological advances have resulted in earlier detection and development of minimally invasive techniques in diagnosis and management strategies. Ultrasound guidance, MRI guidance and stereotactic techniques are now standard methods as the first step in diagnosis of breast cancer. New genetic discoveries such as BRCA testing have resulted in better understanding of the etiology of this disease and implementation of more effective prophylactic measures. The future of breast cancer care continues to rapidly change and evolve. Molecular biology and discovery of different cancer subtypes at the molecular level have opened up new frontiers in approaching breast cancer. The future challenge is development of individualized treatment based on each patient’s cancer molecular subtype.

On April 20, 1894 at the meeting of Clinical Society of Maryland, Halsted introduced his radical mastectomy stating that “a very wide and deep dissection was the only way to deal with this dreadful disease”. He improved the survival rate from almost zero to about 36%. We now expect about 85-90% of the affected women to survive this disease with earlier detection, lesser surgery and multimodality treatment approaches. We now understand that the ultimate outcome is not dependent only on the extent of surgical dissection, but rather on the tumor genetics and molecular biology and behavior of the cancer cells. The future discoveries will result in lesser and lesser surgery and more and more targeted therapies with a goal of 100% survival. Ultimately complete prevention of this disease will be the challenge to overcome by breast cancer researchers in the future.

Dariush Vaziri, M.D., F.A.C.S.

2010 Cases by County

2010 Breast Cancer Cases by County

2010 Estimated US Cancer Cases*

Men
789,620

Women
739,940

Prostate 28% Breast 28%
Lung & bronchus 15% Lung & bronchus 14%
Colon & rectum 9% Colon & rectum 10%
Urinary bladder 7% Uterine corpus 6%
Melanoma of skin 5% Thyroid 5%
Non-Hodgkin lymphoma 4% Non-Hodgkin lymphoma 4%
Kidney & renal pelvis 4% Melanoma of Skin 4%
Oral cavity 3% Kidney & renal pelvis 3%
Leukemia 3% Ovary 3%
Pancreas 3% Pancreas 3%
All Other Sites 19% All Other Sites 20%

Source: American Cancer Society, 2010.
*Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.

2010 Breast Cancer by Age Group

2010 Breast Cancer Cases by Age Group

2010 Breast Analytic Cases

2010 Breast Cancer Analytic Cases

2010 Breast Cancer by Stage

2010 Breast Cancer by Stage

Breast Cancer by Stage Comparison (2000 to 2008)

Breast Cancer by Stage Comparison

2010 Breast Cancer Histology

2010 Breast Cancer Histology

2010 Breast Cancer Rx

2010 Breast Cancer Rx

SOUTHERN REGIONAL MEDICAL CENTER 10/20/2011
First Course Treatment Count (N) Percent (%)
Chemo 11 5.05%
Diagnosis 16 7.34%
Diagnosis, Chemo 7 3.21%
Diagnosis, Surgery 27 12.39%
Diag, Surg, Chemo 16 7.34%
Surgery 53 24.31%
Surgery, Chemo 35 16.06%
Surgery, Hormones 3 1.38%
Surgery, Radiation 14 6.42%
Surg, Rad, Chemo 7 3.21%
Surg, Rad, Horm 3 1.38%
Other 16 7.34%
None 10 4.59%
Total 218 100.00%

Breast Cancer 1st Course Rx Comparison (Cases Diagnosed in 2000 to 2008)

Breast Cancer 1st Course Rx Comparison

Breast Cancer 5 Yr Relative Survival by Stage

Breast Cancer Survival

Breast Cancer 5 Yr Observed Survival by Stage Comparison (Cases Diagnosed in 2003)

Breast Cancer Observed Survival Comparison

2009

  • Cases by County
  • Top 10 New Cancer Cases
  • Prostate Cancer by Stage
  • Prostate Cancer by Age
  • Age Group of Prostate Cancer Diagnosed in 2000 to 2008
  • Prostate Cancer RX
  • Relative Survival by Stage

2009 Cases by County

2009 - Top 10 New Cancer Cases

2009 Prostate Cancer by Stage

2009 Prostate Cancer by Age

Age Group of Prostate Cancer Diagnosed in 2000 to 2008

2009 Prostate Cancer RX

2009 Relative Survival by Stage

2008

  • County of Diagnosis
  • Top 10 Sites
  • Breast Cancer - Subsite
  • Breast Cancer - Race
  • Breast Cancer - Stage
  • Breast Cancer - Histology
  • Breast Cancer - 1st Course RX
  • Breast Cancer - 5 Yr Relative Survival by Best AJCC
  • Observed Survival For Cases Diagnosed in 1998 - 2002 - Data from 113 Facilities [GA]
  • 2008 County of Diagnosis

    2008 - Top 10 Sites

    2008 Breast Cancer - Subsite

    2008 Breast Cancer - Race

    2008 Breast Cancer - Stage

    2008 Breast Cancer - Histology

    2008 Breast Cancer - 1st Course RX

    2008 Breast Cancer - 5th Year Relative Survival by Best AJCC

    Observed Survival For Cases Diagnosed in 1998 - 2002

2007

2007 Annual Report Introduction

  • SRMC - 2007 Top 10 Sites by Sex
  • ACS - 2007 Top 10 New Cases Per Cancer Facts and Figures
  • SRMC - 2007 Cases by County of Diagnosis
  • 2007 Lymphoma Cancer Charts
  • 2007 Ovarian Cancer Charts

The Oncology Program at Southern Regional Health System continues to provide compassionate, state of the art cancer care to Oncology patients in the Southern Crescent and surrounding areas. The Oncology program continues to grow because of the collaborative efforts of a multi-disciplinary team of physicians, nurses, and support staff.

The optimal management of oncology patients requires an ever-growing interdisciplinary approach. The entire spectrum of oncology subspecialties is available to cancer patients to deliver cutting edge care. Evaluation and treatment often involves collaboration of Radiology, Surgery, Radiation Oncology, Gynecologic Oncology, Medical Oncology, and Pathology.

Frequent cancer conferences provide excellent educational opportunities for the staff as well as providing an excellent forum for exchange of ideas across the disciplines. These conferences allow discussion of management of current cases along with occasional visiting lectures by leading experts in the field of oncology.

The Outpatient Oncology Department continues to see a steady increase in the number of patients requiring outpatient care, especially with delivery of systemic therapy, intravenous fluids, and administration of blood products. The department sees an average of 300 patients per month.

Through the community outreach program, Southern Regional Health System continues to provide numerous screening programs, most notably for breast, prostate, and skin cancers. The program continues to be involved in the community by providing educational presentations, community health fairs, and cancer support groups.

The Tumor Registry Program maintains an extensive data base of Oncology patient's cared form through Southern Regional Health System. Multiple clinical trials are available through Southern Regional Health System that provides opportunities for cancer prevention, as well as cutting edge new therapies.

The Oncology Program at Southern Regional Health System continues to grow and provide outstanding and compassionate cancer care. We would like to thank all of the medical staff and employees of Southern Regional Health system for their contributions and for their dedication in making the Oncology Program such a valuable resource for the Oncology patients in the Southern Crescent community.

Should you have any questions about the information contained in the annual report please contact Tumor Registry, Southern Regional Health System at (770) 991-8102.

SRMC - 2007 Top 10 Sites by Sex

ACS - 2007 Top 10 New Cases Per Cancer Facts and Figures

SRMC - 2007 Cases by County of Diagnosis

2007 Lymphoma - Age at DX by Sex

2007 Lymphoma - Race

2007 Lymphoma - First Course Treatment

2002 Lymphoma - 5 year Relative Survival

2006

The Oncology Program at Southern Regional Health System continues to provide compassionate, state of the art cancer care to Oncology patients in the Southern Crescent and surrounding areas. The Oncology program continues to grow because of the collaborative efforts of a multi-disciplinary team of physicians, nurses, and support staff.

The optimal management of oncology patients requires an ever-growing interdisciplinary approach. The entire spectrum of oncology subspecialties is available to cancer patients to deliver cutting edge care. Evaluation and treatment often involves collaboration of Radiology, Surgery, Radiation Oncology, Gynecologic Oncology, Medical Oncology, and Pathology.

As part of our responsibility to the public, we post statistics that cover a broad range of relevant issues to our patients, which can be seen here.

Frequent cancer conferences provide excellent educational opportunities for the staff as well as providing an excellent forum for exchange of ideas across the disciplines. These conferences allow discussion of management of current cases along with occasional visiting lectures by leading experts in the field of oncology.

The Outpatient Oncology Department continues to see a steady increase in the number of patients requiring outpatient care, especially with delivery of systemic therapy, intravenous fluids, and administration of blood products. The department saw an average of 270 patients per month.

Through the community outreach program, Southern Regional Health System continues to provide numerous screening programs, most notably for breast, prostate, and skin cancers. The program continues to be involved in the community by providing educational presentations, community health fairs, and cancer support groups.

The Tumor Registry Program maintains an extensive data base of Oncology patient's cared form through Southern Regional Health System. Multiple clinical trials are available through Southern Regional Health System that provides opportunities for cancer prevention, as well as cutting edge new therapies.

The Oncology Program at Southern Regional Health System continues to grow and provide outstanding and compassionate cancer care. Should you have any questions about the information contained in the annual report please contact Tumor Registry, Southern Regional Health System at (770) 991-8102.

Cases by County of Diagnosis

During 2006, the cancer registry at Southern Regional Medical Center added another 1180 cases to it's database of nearly 14,000 cases dating back to the mid 1980s.

Distribution by Site and Sex

Age of Diagnosis

Sex Distribution

Race Distribution

Stage

Treatment - Initial Therapy

Five Year Relative Survival by Stage

2005

View the entire 2005 Annual Oncology Report (.pdf)