SENTARA CANCER NETWORK · progress against cancer today in regards to precision therapy. Cancer...

SENTARA CANCER NETWORKAnnual Report 2017-18

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TABLE OF CONTENTS2 Sentara Healthcare

6 Sentara Cancer Network Timeline

8 Coordinated Cancer Care

10 Prevention & Early Detection

18 Team Approach

20 Clinical Expertise & Advanced Treatment

24 Clinical Trials & Research

26 Patient Support

32 Personalized Approach

36 Clinical Quality & Outcomes

37 Our Quality Measures

40 Accreditations & Awards

42 Academic Publications

44 Primary Site Tables

46 Sentara Cancer Network Leadership

PERSONAL, ADVANCED, PROACTIVE: OUR PLAN FOR CANCER CAREWe are pleased to share the 2017-2018 Sentara Cancer Network Annual Report. It has truly been an extraordinary year in clinical advances within oncology across the country. The advances highlighted in this report attest to a key trend that is driving progress against cancer today in regards to precision therapy. Cancer therapies are becoming increasingly precise, thereby enabling a more personalized approach to treatment selection. The research into cancer biology is propelling rapid development with many new novel treatments in the pipeline for approval by the FDA.

Thanks to earlier detection, advanced treatment and supportive care, more Americans are surviving cancer than ever before. In fact, there are almost 14.5 million cancer survivors alive in the United States today, and that number is expected to grow to nearly 19 million by 2024, as reported by the American Cancer Society. Due to all of these efforts, many cancers can now be regarded as more chronic in nature. While we have made great strides forward, we realize that the same therapies that were used to treat the disease create their own challenges in the medical community. Addressing the needs of cancer survivors has been a focused area for the Sentara Cancer Network this year as we continue to work with our cancer survivors and

Sentara Cancer Network | 1

Richard A. Hoefer, D.O., FACS Surgical Oncology Medical Director, Sentara Cancer Network

Thomas A. Alberico, M.D. Medical Oncology Chair, Oncology High Performance Team

Cindy Allen Vice President, Sentara Cancer Network

James Schneider, M.D., FACS Surgical Oncology Cancer Liaison Physician (CLP), Sentara Cancer Network

their families to ensure we have the right services and programs in place to not only meet their needs but to help them fully embrace their survivorship.

Throughout the report, you will see the commitment that the Sentara Cancer Network has on improving the health of our community. Our physicians, nurses and staff participate in many prevention, education and screening programs to raise the awareness for cancer support and improve the overall health of our communities.

One integral way we have done this is with the new Sentara Cancer Center in Norfolk, VA. We broke ground on this $93.5 million project in 2018 and expect to complete it in 2020. This state-of-the-art center is modeled after major cancer centers throughout the nation and builds upon the exemplary cancer care services currently provided by Sentara.

As the only Integrated Cancer Program in Virginia, as designated by the American College of Surgeons Commission on Cancer, we are in a position to provide expert care close to home. Through our multidisciplinary team approach, evidence-based protocols, cutting-edge technologies and advanced clinical trials, patients can rest assured that they are receiving quality care throughout our entire Sentara Cancer Network. This Annual Report summarizes many of our accomplishments, including:

• Adding new diagnostic and treatment technologies to our arsenal of cancer-fighting tools as they become available

• Welcoming outstanding new physicians and staff to our team

• Listening to what our patients are telling us, and focusing on access and refining processes to improve our patients’ experiences

• Creating innovative new programs, such as our next-generation molecular lab capacities

• Continuing to build our “Living Beyond Cancer” Survivorship Program, to enhance our patients’ well-being and long-term health

• Increasing our clinical research activity and expanded clinical research accrual

• Creating a safe environment for care delivery

• Providing our community with cancer screening services and cancer prevention education

As we reflect on the outstanding accomplishments for this year, and for the excitement that is ahead with the transformation in oncology care, we are privileged to share these accomplishments, as well as many more highlighted throughout this report.

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SENTARA HEALTHCARE

127 in Hampton Roads 1 in Northern Virginia 2 in Blue Ridge 1 in South Boston 1 in Northeastern

North Carolina

ACUTE CARE HOSPITALS

Sentara Albemarle Medical Center Elizabeth City, NC182 Beds

Sentara CarePlex Hospital Hampton, VA224 Beds

Orthopaedic Hospital at Sentara CarePlexHampton, VA18 Beds (included in Sentara CarePlex Hospital license)

Sentara Halifax Regional HospitalSouth Boston, VA192 Beds

Sentara Heart Hospital Norfolk, VA 112 Beds (included in Sentara Norfolk General Hospital license)

Sentara Leigh HospitalNorfolk, VA 250 Beds

Orthopaedic Hospital at Sentara LeighNorfolk, VA48 beds (included in theSentara Leigh Hospital license)

VIRGINIA

Charlottesville

HarrisonburgWoodbridge

Williamsburg

Norfolk

Suffolk

Elizabeth City, NC

South Boston Virginia Beach

Hampton Roads Blue Ridge Northern Virginia North Carolina South Boston

NORTH CAROLINA

Hampton


Nearly 28,000 members of the team

Four medical groups With more than 1,000 physicians and advanced practice clinicians at 222 locations

12 acute care hospitals

Advanced imaging and diagnostic centers

Nursing and assisted-living centers

Home care and hospice

Optima Health Plan Serving 455,000 members

Sentara College of Health Sciences

Sentara Quality Care Network A clinically integrated network

SENTARA HEALTHCARE AT A GLANCE

Sentara Princess Anne HospitalVirginia Beach, VA174 Beds

Sentara Martha Jefferson HospitalCharlottesville, VA176 Beds

Sentara RMH Medical CenterHarrisonburg, VA238 Beds

Sentara Norfolk General HospitalNorfolk, VA525 Beds

Sentara Virginia Beach General HospitalVirginia Beach, VA276 Beds

Sentara Northern Virginia Medical CenterWoodbridge, VA183 Beds

Sentara Williamsburg Regional Medical CenterWilliamsburg, VA145 Beds

Sentara Obici HospitalSuffolk, VA 176 Beds

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SENTARA CANCER NETWORK OVERVIEW

A diagnosis of cancer is life-changing for patients and their loved

ones. Nobody understands this more than the care teams at the

Sentara Cancer Network. Our experts dedicate their professional lives

to providing exceptional care that extends the longevity and quality

of life for everyone touched by cancer. We’re proud of our distinction

as the only Integrated Network Cancer Program (INCP) in Virginia as

designated by the American College of Surgeons Commission on

Cancer. Our integrated network of 12 acute care hospitals in Virginia

and North Carolina makes us uniquely equipped to offer advanced

treatments conveniently within a patient’s community.

Here are just a few reasons why patients choose and trust the

Sentara Cancer Network with their cancer treatment:

PERSONALIZED APPROACH TO CANCER CARE

The ongoing development of precision therapies means cancer

treatments are no longer one-size-fits-all. Instead of targeting the

body part where cancer originated, new treatments enable us to

target the specific genes and proteins that promote cancer cell

growth. The goal is individualized treatment for every patient. Our

experts continue to work tirelessly to expand the knowledge base

and applications of molecular testing, immunotherapy and other

targeted therapies in order to make this a reality.

PATIENT SUPPORT

We have a robust supportive care program that ensures patients

and their loved ones feel compassionately looked after throughout

every step of their journey. Our team includes nurse navigators,

genetics counselors, social workers, patient and family advocates,

registered dietitians, support groups and palliative care specialists.

CLINICAL EXPERTISE

Our experienced physicians are focused on diagnosing cancer

earlier, advancing treatments through clinical trials and research,

and providing supportive, integrative care. We continue to expand

the Sentara team with highly sought-after physicians and staff.

TEAM APPROACH

Our multidisciplinary teams of doctors, advanced practice clinicians,

nurses, nurse navigators and other specialists work collaboratively

to ensure each patient receives the best treatment for his or her

unique health needs. These teams meet regularly to review cases

and ensure appropriate care. It’s this type of commitment that

fosters trust among our patients and community.

Non-Hodgkin Lymphoma

Thyroid


9,048Patients were added to the network registries in 2016

158,507Patients documented in network registries since 1995 to 2016

3,000+Patients accrued to clinical trials and other research efforts throughout the network in 2016

3,369Patients presented at tumor boards in 2016Source: Sentara Cancer Network, Cancer Registries

Breast

Lung, Bronchus - Non-small Cell

ColorectalProstate

Melanoma - Skin

Bladder

Non-Hodgkin Lymphoma

Uterus

Pancreas

Kidney & Renal Pelvis

SENTARA CANCER NETWORK

TOP 20 TUMOR SITES 2016

(Note: 41 other sites make up the other 11% of caseload)

27%

12%

9%8%7%

5%

5%

4%3%3%

3%

1%1%1%

2%2%

2%2%

2%

1%

Thyroid

Tongue

Stomach Lung, Bronchus - Small Cell

Leukemia Brain

Miscellaneous

Myeloma

EsophagusLarynx

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1990sRadiosurgery

Autologous stem

cell transplantation

Monoclonal

antibody therapy

High-dose

rate remote

afterloading

brachytherapy

2000sHyperthermic intraperitoneal chemotherapy

(HIPEC)

Robotic radiosurgery with CyberKnife®

Intraoperative radiation (Intrabeam)

SIR-Spheres®

Nurse navigator

da Vinci® robotic surgery

TransOral robotic surgery for head/neck

cancer (TORS)

Transanal endoscopic microsurgery (TEMS)

High-dose radiation for skin cancer

Radiofrequency ablation and cryoablation

for lung cancer

Positron emission tomography/Computed

tomography (PET/CT)

Whipple surgery for pancreatic cancer

Endobronchial ultrasound (EBUS)

2010s CT lung screening program

TheraSphere®

Electromagnetic navigational bronchoscopy (ENB)

Minimally invasive esophagectomy

Cancer rehabilitation

Endoscopic neurosurgery

Interleukin-2 (IL-2)

3D mammography (tomosynthesis)

Alliance for clinical trials in oncology and NRG

Oncology memberships

Laparoscopic pancreaticoduodenectomy

Breast tumor radioactive seed localization

Microwave ablation and cryoablation

Advanced neurosurgical oncology: awake

craniotomy and brain mapping; NICO BrainPath

and 6 Pillars Approach; NeuroBlate; and Optune

Next-generation sequencing molecular testing

Thoracic fast-track clinic

DTI tractography

Comprehensive gynecologic oncology program

Sentara-EVMS Comprehensive Head and

Neck Program

Sentara Neuro-Oncology Center

Sentara-EVMS Skull Base Center

Targeted therapies

Check point inhibitors

Medrobotics Flex® Robotic System

Lutathera®

SENTARA CANCER NETWORK TIMELINE


Dr. Mary Guye using Intrabeam technology at Sentara CarePlex Hospital.

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SENTARA CANCER NETWORK CANCER CENTERS

Sentara Cancer Network is dedicated to making the diagnostic and

treatment process as easy and stress-free as possible for patients

and caregivers. We realize that people diagnosed with cancer often

have multiple appointments with specialists in a single day. We

continue to look for ways to streamline the care process so that

patients have more time to focus on healing.

The 12 acute care hospitals and two dedicated cancer centers that

comprise the Sentara Cancer Network serve as strong community

assets throughout the region by providing comprehensive services

close to where people live and work. For years, Sentara RMH Hahn

Cancer Center and Sentara Martha Jefferson Cancer Center have

been providing outpatient care and support services in centralized,

comprehensive settings. Sentara Healthcare is drawing on the

successes of these cancer centers to create a new cancer center

on the Sentara Leigh Hospital campus in Norfolk.

UNDER CONSTRUCTION: NEW SENTARACANCER CENTER, OPENING 2020

Sentara Healthcare has invested $93.5 million to build the Sentara

Cancer Center. This new center will bring together expert care

teams from Sentara Medical Group, Eastern Virginia Medical


School (EVMS), Virginia Oncology Associates, and other community

physicians to provide compassionate, personalized cancer care. Our

253,000-square-foot facility is set to open in 2020.

Patient and caregiver input was instrumental in creating the

center, which will feature:

Centralized cancer services: Sentara Cancer Center brings all

members of a patient’s care team together under one roof to

address needs in a healing environment. Patients will be able to

receive same-day consultations from specialists across a variety

of disciplines. This co-location allows for more fully integrated

palliative care, rehabilitation and survivorship programs, as well as

enhancement of wellness and chemoprevention programs.

Support services: The center provides streamlined access to

important support services, including support groups for patients

and caregivers, financial counseling, nutritional counseling,

supplementary services like massage and mastectomy tattooing,

as well as a retail center.

Research partnerships: Our increased collaboration with Virginia

Oncology Associates, Eastern Virginia Medical School and

numerous clinical community partners will allow us to put the

latest research findings into action through clinical trials.

Physicians will be able to seamlessly translate clinical research

findings into the latest cancer treatments and advanced technology

directly to patients.

SENTARA RMH HAHN CANCER CENTER

The Sentara RMH Hahn Cancer Center is a Commission on Cancer-

recognized Comprehensive Community Cancer Program, serving

the city of Harrisonburg, Virginia, and its surrounding counties. Its

highly skilled cancer specialists utilize advanced technology, including

Breast Molecular Imaging, for early diagnosis and to collaboratively

treat all solid tumors as well as benign and malignant hematological

disorders. Individualized, targeted treatment is paired with supportive

services including patient psychosocial counseling, nutritional care,

survivorship classes, massage and a retail Image Recovery—all

available onsite.

SENTARA MARTHA JEFFERSON CANCER CENTER

The Sentara Martha Jefferson Cancer Center in Charlottesville,

also a designated Comprehensive Community Cancer Program,

offers innovative, comprehensive care for all solid tumors as well as

benign and malignant hematological disorders. Cancer specialists

utilize weekly general and breast tumor boards and biweekly rectal

tumor boards for multidisciplinary discussion regarding diagnosis

and treatment. The most advanced treatment is available including

targeted and biological therapies and Varian’s Calypso® soft tissue

Beacon® transponders for radiation. Supportive services include a

financial counselor, chair massage, a social worker, RN Navigators,

dietician, Certified Genetic Counselor and support groups.

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Sentara Halifax Regional Hospital launched 3D mammography this year.

PREVENTION & EARLY DETECTION

The number of people diagnosed with cancer is expected to grow

36 percent by 2030. Cancers of the breast, prostate, colorectal,

melanoma and lungs will continue to be the most commonly

diagnosed diseases.

Sentara is dedicated to finding new ways to detect cancer at its

earliest stages, when the disease is most treatable. We know that

prevention and early detection are paramount to ensuring that

everyone who is affected by cancer has a chance to enjoy a long,

full life.

BREAST CANCER SCREENINGS

Our 10 comprehensive breast centers employ full-time radiologists

who have fellowship training in breast imaging. Tomosynthesis

technology, or 3D mammography, allows our radiologists to spot

cancer more easily and earlier than before, especially in dense

breast tissue where cancer tumors are harder to detect. Our

online scheduling system and mobile mammography unit make

screenings more accessible to women.

COLORECTAL CANCER, COLONOSCOPIES AND FECAL TESTS

Sentara took part in the national “80% by 2018” initiative launched

by the National Colorectal Cancer Roundtable. Our shared goal is to

get 80 percent of adults aged 50 years and older regularly screened

for colorectal cancer by 2018.

In 2017, Sentara initiated a best practices alert with Sentara Medical

Group. The electronic medical record alert reminds primary care

physicians to address colorectal screening during a patient’s

visit. We’re also stocking offices with take-home, mail-in fecal

immunochemical tests (FIT) to give to patients who choose not


““The key to beating many types of cancer is diagnosing and treating it early. For lung cancer we use low-dose CT lung screening to help find cancer early, when it is most treatable. Lung cancer is often not diagnosed until it has spread because it does not show many symptoms, so CT lung screening can truly save patients’ lives.”

— Raffaele Marchigiani, M.D., Thoracic Surgeon, Sentara Surgery Specialists

to undergo a colonoscopy. These tests screen for hidden blood

in stool, an early indicator of cancer. A colonoscopy is still the

recommended screening, but FIT is used for patients if needed. A

patient will still need a colonoscopy after a FIT test if any abnormal

findings are discovered. In late 2016, we began testing a text

message alert system that notifies patients when it’s time for a

screening or when a screening is overdue.

Also in 2017, Sentara began offering FIT to uninsured and under-

insured patients at the Sentara Ambulatory Care Center in

Norfolk. This population is among the least likely to get colorectal

screenings. Our on-site patient navigator ensures patients

complete FIT and schedules free colonoscopies when needed.

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Low dose CT lung screening.


“

LUNG CANCER AND LOW-DOSE COMPUTED TOMOGRAPHY (LDCT) SCANS

LDCT gives a more detailed look at the lungs than chest X-rays,

making it one of the best tools available for detecting lung cancer

at its earliest stage. In 2017, Sentara Halifax Regional Hospital

and Sentara Northern Virginia Medical Center began offering this

service, expanding the program to all Sentara Cancer Network

hospitals. LDCT is offered at 23 Sentara hospital and ambulatory

clinic locations. Out of the nearly 3,000 screenings we completed

in 2017, 37 people were diagnosed with lung cancer. More than

half of those patients had stage 1 lung cancer.

HEAD, NECK AND THYROID CANCER SCREENINGS

Endocrinologists and head and neck surgeons from Sentara EVMS

Comprehensive Head and Neck Center in Norfolk participate in

free head, neck and thyroid cancer screenings every April during

national Head and Neck Cancer Awareness Month. Patients

identified as having a potential thyroid problem undergo ultrasound

tests that same day. Counselors are available to meet with patients

who need to see a specialist for a follow-up appointment. Smoking

cessation resources are provided to current smokers. A team of

community educators, navigators, and counselors are available for

patients requiring follow-up.

GYNECOLOGIC CANCERS AND SCREENINGS

With no reliable screening test (and few early warning signs) for

ovarian, uterine, vaginal and vulvar cancers, physician and patient

education and awareness remain at the forefront of the Sentara

Cancer Network efforts for the early detection of gynecologic

cancers. We continue to promote routine Pap tests to detect changes

in cervical cells that can indicate cervical cancer. Our gynecologic

cancer experts meet regularly with providers to provide education

about cancer symptoms. In 2017, we created new materials designed

to teach women about cancer warning signs.

The advent of new technologies opens the door for advanced cancer screenings and the chance for detecting cancer in earlier stages. Patients should speak with their physician about their medical history and pertinent risk factors to determine which cancer screenings are appropriate for them.”

— Janete Mills, M.D., Radiation Oncologist,

Sentara Albemarle Medical Center

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COMMUNITY EVENTS

Our cancer educators inform

members of the community about

cancer prevention and detection.

These specialists coordinate

the Sentara Cancer Network

involvement at screening events,

health fairs, speaking engagements

and other community affairs. In

2018, more than 15,000 individuals

participated in community cancer

events. We also support fundraisers

for local and national nonprofit

cancer organizations, such as the

American Cancer Society’s Relay

for Life®, Leukemia & Lymphoma

Society Light the Night® and Susan

G. Komen Race for the Cure®.

Breast cancer survivors event at Sentara Northern Virginia Medical Center.

Community event at Sentara Northern Virginia Medical Center.

Sentara Albemarle Medical Center Relay for Life®. Colon Cancer 5k.

Cancer survivors at Sentara Norfolk General Hospital celebrate National Cancer Survivors Day.

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Sentara RMH Medical Center cancer community event.

Party on Wheels Mobile Mammography event at Sentara Northern Virginia Medical Center.

(L-R) The Honorable S. Chris Jones, Member, Virginia House of Delegates; The Honorable Kenneth Alexander, Mayor, City of Norfolk; Howard Kern, President and CEO, Sentara Healthcare; The Honorable Ralph Northam, Governor, Commonwealth of Virginia; Michael Gentry, Executive Vice President and COO, Sentara Healthcare; Frank McKenna, Cancer Survivor.

Dr. Scott Cross and Dr. Tabetha Sundin host a Facebook Live to talk about molecular testing and new therapies for lung cancer.

Dr. Gregory FitzHarris, a colorectal surgeon with the Sentara Cancer Network, provides some information about the new colorectal screening guidelines on Facebook Live.

Head and neck surgeons with the Sentara EVMS Comprehensive Head and Neck Center demonstrate on Facebook Live how surgical robots are becoming more advanced.

Sentara Cancer Center groundbreaking ceremony.

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Frank McKenna remembers being

stunned when his doctor told

him the annoying cough he was

experiencing was a symptom of

lung cancer.

SENTARA CANCER NETWORK SURVIVOR

FRANK MCKENNA “Cancer changes your whole life... I want people to know that we are in this together.”

FRANK MCKENNA LUNG CANCER SURVIVORSTRIKING

BACK

the first line of treatment and received

two weeks of radiation on his left femur.

Unfortunately, the McKennas received

more difficult news shortly after Frank’s

diagnosis when his daughter, Kaitlyn, was

diagnosed with melanoma on her right ear.

They rallied around each other.

“My family has been unbelievably supportive

through this whole situation,” Frank said of

his wife of 34 years, Debbie, and their three

grown kids. “They’ve helped with everything

I’ve needed. They’ve been fantastic.”

Adjusting the Treatment

A few months into taking his daily

chemo pill, Frank felt awful. He had no

energy or appetite. He’d lost weight. It

was November and his family feared he

wouldn’t make it to Christmas. His scans

showed the cancer was progressing.

Dr. Radkar ordered more in-depth genetic

testing that isolated a gene mutation,

T790M. Frank switched to a new daily

chemo pill, which targets that specific

mutation; he began feeling better within days.

“I thought, ‘You’ve got the wrong chart.

This can’t be right,’” said Frank, 57, a

personal trainer in Virginia Beach who

received the news in the summer of 2016.

When Frank first saw his primary care

physician in June 2016 for a nonproductive

cough, his doctor prescribed antibiotics and

allergy medicine. When the cough failed

to clear up, Frank had a chest X-ray that

revealed his left lung was full of fluid.

Making the Diagnosis

Doctors diagnosed Frank with stage 4 lung

cancer in July 2016. The cancer had also

spread to various bones. His doctors were

surprised that someone with his condition

wouldn’t have felt winded just walking to

the mailbox, but Frank, who works out five

days a week, had no trouble breathing or

with fatigue.

Since Frank was a nonsmoker and

extremely healthy, his oncologist,

Dr. Gauri Radkar, ordered tests on the

lung fluid that pointed to a genetic link to

the cancer.

Frank took a daily chemotherapy pill as

Giving Back

Frank, who was treated at several Sentara

hospitals, receives monthly infusions and

takes calcium supplements to strengthen

his bones. Scans show the medication is

keeping the cancer from spreading. He also

sees a Sentara cardiologist to make sure

his chemo pill isn’t harming his heart, which

has been fine.

“Today I feel perfectly fine,” Frank said. “My

mindset is I’m going to beat this. Even if it

hasn’t happened before, there’s no reason I

can’t beat it with all our medical advances.”

Frank’s license plate, “WIN DAY,” shows his

philosophy that he shares with his personal

training clients to “win the day.”

“Win the day. Don’t give up. Make history,”

he said. “Some days you may not win, but

you will wake up and win tomorrow.

“Cancer changes your whole life,” Frank

said. “I want people to know that we are

in this together. Here’s a guy with stage 4

lung cancer and he’s doing the same thing.

If I can inspire even one person I’m all for

doing what I can do to help.”


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“

Medical OncologistPathologist

Palliative Care Specialists

Occupational Therapists

Speech Therapists

Physical Therapists

Genetic Counselor

Case Manager

Patient Navigator

Surgeon

Surgical Oncologist

Radiation Oncologist

Radiologists

Oncology Certified Nurse

Chemotherapy Trained Nurse

Oncology Social Worker

Psychologist

Dietitian/Nutritionist

TEAM APPROACH

The Sentara Cancer Network is known for our

teams of dedicated cancer specialists who

provide compassionate care personalized

for each patient’s unique situation. Our

experts work collaboratively, always keeping

the patient’s medical needs and personal

preferences at the forefront of all decision-

making. This dedicated focus bolsters patient

confidence and trust in the care team.

MULTIDISCIPLINARY CANCER CARE TEAM

“Each of our patients benefit from a team approach to cancer care. Not only do physicians from many different specialties meet at tumor boards to review patient cases and develop the best treatment plan, but our team throughout the entire cancer journey works together at every step of the way to provide comprehensive cancer care.”

— Richard Hoefer, D.O., Medical Director

for Sentara Cancer Network


“expertise of cancer specialists at other Sentara hospitals.

We leverage best practices to ensure patients receive the same

high-quality treatment and care at every Sentara location.

“Patients benefit from having physicians with different expertise review their case together, to develop a treatment plan that synthesizes input from a group of specialized head and neck cancer physicians, to develop the best plan tailored to that individual patient and specific cancer.”

— Daniel W. Karakla, M.D., FACS, Professor, Head and Neck Oncology, Thyroid and Parathyroid Surgery, EVMS Ear, Nose, and Throat Surgeons

Members from various teams at each of our hospitals work

together in committees to review clinical quality metrics, analyze

learning opportunities and discuss ways to improve timeliness and

quality of care for all patients across the entire Sentara

Cancer Network.

ABOUT OUR TUMOR BOARDS

Cancer is a complex condition, and each patient’s medical

situation requires an individualized care approach. Tumor boards

are comprised of specialists from a variety of disciplines who

meet to discuss the best ways to care for a patient’s specific

diagnosis. Tumor boards meet regularly, and often times utilize

web technology in order to incorporate specialists from

multiple locations.

This multidisciplinary care team may consist of a medical, surgical

and radiation oncologist, pathologists, diagnostic and radiologists,

nurse navigators and social workers. Depending on the cancer

type, a tumor board may also include gynecologists, urologists,

pulmonologists, nephrologists, transplant surgeons, plastic

surgeons and other experts.

One aspect that makes Sentara Cancer Network tumor boards

unique is the ability to work together in an integrative network

across all 12 hospitals. When needed, a tumor board may tap the

A team review: Our tumor board

CLINICAL EXPERTISE & ADVANCED TREATMENT At Sentara, we remain dedicated to

offering a comprehensive suite of cancer

treatments that provide maximum

benefits to patients. We actively recruit

and employ leading cancer specialists

bringing the best clinical expertise

directly to patients. Our physicians

have expertise in the latest treatment

technologies and capabilities, including:


Sentara CarePlex Hospital

Sentara Halifax Regional Hospital

Sentara Leigh Hospital

Sentara Martha Jefferson Hospital

Sentara Norfolk General Hospital

Sentara Northern Virginia Medical Center

Sentara Obici Hospital

Sentara Princess Anne Hospital

Sentara RMH Medical Center

Sentara Virginia Beach General Hospital

Sentara Williamsburg Regional Medical Center

DIAGNOSTIC

3D Mammography

Breast-specific gamma imaging

Low Dose CT Lung Screening

Endorectal ultrasound

Endobronchial ultrasound

Navigational bronchoscopy

AxuminNETSPOT

SURGICALda Vinci® surgical robotFlex Robot

Hyperthermic Intraperitoneal Chemotherapy (HIPEC)


Video-assisted thoracic surgeryAdvanced Gyn Program

RADIATION ONCOLOGYStereotactic radiosurgery (SRS)CyberKnife®

SIR Spheres and TheraspheresBrachytherapy/radioactive seed implant therapyHigh-dose rate (HDR)Accelerated partial breast irradiation (APBI)Intraoperative radiation therapy (IORT)

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Sentara Halifax Regional Hospital










DIAGNOSTIC

3D Mammography

Breast-specific gamma imaging

Low Dose CT Lung Screening

Endorectal ultrasound

Endobronchial ultrasound

Navigational bronchoscopy

AxuminNETSPOT

SURGICALda Vinci® surgical robotFlex Robot

Hyperthermic Intraperitoneal Chemotherapy (HIPEC)


Video-assisted thoracic surgeryAdvanced Gyn Program

RADIATION ONCOLOGYStereotactic radiosurgery (SRS)CyberKnife®

SIR Spheres and TheraspheresBrachytherapy/radioactive seed implant therapyHigh-dose rate (HDR)Accelerated partial breast irradiation (APBI)Intraoperative radiation therapy (IORT)

22 |

STEREOTACTIC RADIOSURGERY (SRS)

Stereotactic radiosurgery is a non-surgical radiation therapy

that uses 3D imaging to target high doses of radiation to the

affected area with minimal impact to the surrounding healthy

tissue. Sentara offers this advanced technology at Sentara

Martha Jefferson Hospital, Sentara Norfolk General Hospital,

Sentara Obici Hospital and Sentara RMH Medical Center.

ADVANCED GYNECOLOGIC ONCOLOGY PROGRAM

Sentara Virginia Beach General Hospital is home to the only

dedicated women’s health and gynecologic cancer program

in Hampton Roads. Our gynecologic oncologists use the da

Vinci Xi surgical system to perform highly complex procedures.

This system is the most advanced, intuitive robotic surgery

system available in the Hampton Roads region. The Xi model

provides crystal-clear 3D, high-definition views of the surgical

site. It goes beyond other da Vinci systems, enabling surgeons

to perform precise multiquadrant surgeries on several different

parts of the abdomen instead of one localized area. In 2017,

we added pathologists who specialize in gynecologic cancer to

our expert team.

“Having a group of experienced and specialized physicians working together with cutting-edge treatment and technologies means our patients have access to some of the best cancer care available anywhere. The Sentara Cancer Network provides a platform for multidisciplinary tumor boards and cooperation across different disciplines. We are constantly advancing our treatments with new technology. This year the Flex Robot was acquired, which is revolutionizing the way complex surgeries for head and neck, colon and gynecologic cancers are performed—resulting in better

outcomes for patients.”

— Marybeth S. Hughes, M.D., FACS, Chief of Surgical Oncology, EVMS Department of Surgery


INTERVENTIONAL RADIOLOGY

Interventional radiologists play a critical and growing role as part

of the Sentara Cancer Networks multidisciplinary team approach

in the treatment of cancer and cancer-related disorders. This is a

rapidly evolving field where many of the innovative techniques for

diagnosing and treating cancer has led to increased quality of life

and increased survival for patients living with a cancer diagnosis.

Interventional oncology procedures provide minimally invasive,

targeted treatment of cancer for patients whose cancer cannot

be surgically removed or effectively treated with systemic

chemotherapy or radiation. When combined with current

innovations, these image-guided techniques are able to treat the

cancers while minimizing potential damage to other organs in the

body. In most cases, these procedures are done on an outpatient

basis. Interventional radiology procedures may be combined

with other cancer treatments, which include radiation therapy,

chemotherapy or cancer surgery. The Interventional radiologists

within the Sentara Cancer Network have been at the forefront of

bringing the latest technology and procedures to the communities

we serve, providing a comprehensive approach to care. Some

examples of these procedures include:

Ablation procedures – uses extreme heat or cold to destroy a tumor.

Embolization procedures – shrinks a tumor by cutting off its

blood supply.

Kyphoplasty and vertebroplasty – treat spine fractures caused by

spinal tumors or other cancers.

Paracentesis – treats a cancer complication called ascites. It

occurs when fluid builds up inside of a patient’s abdomen which

causing swelling.

Venous access procedures – through tubes put under a patient’s

skin, access is created with ports to place PICC lines and catheters.

These allow care teams to draw blood or give medication through

the same access tube instead of multiple access points and tubes.

Stent placement – these help to treat blockages associated with

bile duct, colorectal, esophageal or tracheobronchial cancer.

The da Vinci Xi surgical system provides crystal-clear 3D, high definition views of the surgical site.

24 |

CLINICAL TRIALS & RESEARCH Clinicians and academic researchers in the Sentara Cancer Network

partner with Virginia Oncology Associates, Eastern Virginia

Medical School, George Mason University and other national and

local healthcare organizations to conduct research that elevates

patient care.

As a leading contributor to national research, we’re committed

to participating in promising clinical trials that make new first-line

therapies available to patients right now. Our team also participates

in research that may lead to better options for prevention, diagnosis

and treatment in the future. One constant goal is to improve our

patients’ quality of life.

In 2017, several research efforts focused on finding more

conservative, effective ways to treat patients with less risk of side

effects. Studies also focused on preventing cancer recurrence and

enhancing post-treatment quality of life. Our research efforts are

diverse and include:

CONSERVATIVE TREATMENTS FOR BREAST CANCER

A clinical trial (National Cancer Institute Trial “Comparison of

Axillary Lymph Node Dissection With Axillary Radiation for Patients

With Node-Positive Breast Cancer Treated With Chemotherapy”

A011202) is underway to determine whether women with node-

positive breast cancer can forego axillary lymph node dissection

during surgery and receive only radiation. This conservative

approach would reduce the occurrence of painful lymphedema and

help patients return to daily activities faster.

Women with ductal carcinoma in situ (DCIS), a noninvasive breast

cancer, typically get some form of treatment, such as a lumpectomy

or radiation. The Comparison of Operative to Monitoring and

Endocrine Therapy (COMET) trial is testing an active surveillance

approach similar to what doctors use to closely monitor prostate

cancer in men. Breast specialists aggressively watch for signs of

change, initiating treatment only when absolutely necessary.

PREVENTING BREAST CANCER RECURRENCE

The National Cancer Institute Breast Cancer Weight Loss (BWEL)

study explores whether weight loss can reduce cancer recurrence

and improve overall survival and quality of life. The ABC trial

examines the daily use of aspirin as an adjuvant therapy to prevent

cancer recurrence in women with node-positive breast cancer.


NEW TREATMENTS FOR BRAIN CANCER

Sentara is participating in two research studies focused on

treatments for glioblastoma, an aggressive brain cancer. The

METIS trial tests the efficacy of a glioblastoma treatment device

called Optune® on patients whose non-small cell lung cancer has

metastasized to the brain. The device attaches to the scalp and

emits low-intensity electrical fields, called tumor treating fields, to

stop the division of cancer cells or destroy them.

In the Toca 5 trial, patients with glioblastoma receive an injection of

a medication called Toca 511 directly into the resected cavity after a

tumor is removed. The medication binds itself to remaining cancer

cells in the brain. Patients then take an oral pill called Toca FC. The

oral medication combines with the injected medication to kill off

cancerous cells.

LUNG CANCER RESEARCH

In 2017, we began enrolling patients with non-small cell lung

cancer into the Adjuvant Lung Cancer Enrichment Marker

Identification and Sequencing Trial (ALCHEMIST). The study looks

for genetic markers for epidermal growth factor receptor (EGFR)

mutations and anaplastic lymphoma kinase (ALK) rearrangements

to help determine if a patient will benefit from targeted therapy.

Sentara researchers also participated in a study called “Reducing

surgical complications in newly diagnosed lung cancer patients

who smoke.”

“A multidisciplinary team of specialists collaborates during supported disease and organ specific tumor boards to review cases and determine the best course of treatment for each patient presented.”

— Scott Cross, M.D.

26 |

PATIENT SUPPORT Patients undergoing cancer treatments need a dedicated,

caring team of medical experts and loved ones to support them

throughout the journey. Because cancer takes a toll on everyone

it touches, these loved ones also need support. At Sentara, we’ve

tailored a supportive care program that encompasses a wide range

of services for patients and their caregivers.

PATIENT NAVIGATORS

Cancer care typically involves seeing multiple specialists and several

types of treatments. This can be overwhelming, especially to

patients struggling to come to terms with a diagnosis. Our cancer

patient navigators offer emotional support, facilitate communication

among care team members, answer questions about diagnosis,

treatment and test results, and help resolve any barriers to care. These

registered nurses also assist with follow-up care, ensuring survivors

continue to receive necessary scans and tests.

LIVING BEYOND CANCER SURVIVORSHIP PROGRAM

The Living Beyond Cancer Survivorship Program supports patients

and caregivers during the transition from active treatment to

survivorship. The two-hour classes are offered in every Hampton

Roads center, Sentara Northern Virginia Medical Center and Sentara

RMH Hahn Cancer Center. A physical or occupational therapist

offers advice about safe physical activity and exercises, a registered

dietitian shares tips for healthful eating and weight control, and a

licensed clinical social worker teaches techniques for coping with

stress, fear and anxiety. The team also provides education about

resources that can ease the adjustment to life’s “new normal” as a

cancer survivor.

www.sentara.com/LivingBeyondCancerClass

SUPPORT GROUPS

Patients and caregivers benefit from talking to others who

understand what they’re going through. However, it can be

challenging to find the time and the means to get away for these

much-needed conversations. To easily connect patients and

caregivers, Sentara uses a variety of methods to host support groups.

We offer in-person meetings at various Sentara facilities, as well as

telephonic support groups and social media support groups, including

secured, invite-only Facebook support groups that are overseen by

patient navigators, community educators and social workers.

www.sentara.com/CancerSupportGroups


DIET AND NUTRITION

Good nutrition is key to keeping up strength, building a strong

immune system and helping the body heal. Unfortunately, cancer

treatments can cause nausea and diarrhea, and make foods smell

and taste unappetizing. Our inpatient registered dietitians screen all

Sentara hospital patients daily for signs of feeding distress, such as

decreased appetite, weight loss and swallowing problems. These

experts work one-on-one with patients to manage symptoms and

find dietary changes that work.

Towards the end of 2016, Sentara Norfolk General Hospital

dedicated one inpatient dietitian to working with patients with head

and neck cancers. This dietitian works with caregivers and patients

87%2017 CAN participants lost weight

to ensure a successful transition from hospital to home for patients

with feeding tubes. The dietitian also attends tumor boards and

rounds with head and neck cancer specialists, providing critical

expertise to physicians and nurse navigators.

For continuity of care, oncology

focused outpatient dietitians are

present in radiation oncology

programs to continue to provide

nutrition assessment and education

to patients during their treatment.

CLINICAL SOCIAL WORKER

Oncology licensed clinical social workers

(LCSW) support the psychosocial needs of

patients and family members through the

cancer care journey, from diagnosis through

survivorship. Oncology social workers

at Sentara Norfolk General Hospital,

Sentara Martha Jefferson Hospital and

Sentara RMH Medical Center provide a

breadth of services, such as developing

coping strategies to manage fear, anxiety

and treatment side effects, helping

with financial and transportation issues,

providing referrals to community resources

and assisting with advanced care planning.

In 2017, Sentara worked with Eastern Virginia

Medical School to modify a psychosocial

distress screening tool developed by the

National Comprehensive Cancer Network.

Modifications were made based on input

from Sentara patients and caregivers. The

tool helps nurses, oncology social workers

and other care team members understand

the distress a patient may be feeling and

determine which patients could benefit from

counseling or other types of support.

28

““It takes tremendous bravery to face a cancer diagnosis. It takes internal strength and resilience to move through and complete treatment. Patients aren’t aware of these strengths when they begin a cancer journey but by the end, they embody strengths they never knew they had.”

— Karen Woodhouse, Licensed Clinical Social Worker


PALLIATIVE CARE

Palliative medicine takes a holistic approach to improving the

quality of life for patients in active treatment and their caregivers.

Research suggests that patients who use palliative care services

enjoy a better quality of life. Sentara specialists introduce palliative

care early in the disease treatment process to ensure patients and

caregivers are aware of the resources available to them. Palliative

care team members include physicians, nurses, social workers,

pharmacists, dietitians and chaplains who are experts in disease

treatment and symptom management. These specialists work

collaboratively to meet the emotional, spiritual and psychosocial

needs of both patients and caregivers. We customize services

based on a patient’s values and preferences.

HOSPICE

Hospice services are appropriate when a patient’s disease no

longer responds to treatment. The goal is to offer comfort and

dignity during a patient’s last phase. Hospice team members

include nurses, home health aides, social workers and pastoral

staff. These specialists provide patient care in a variety of settings,

such as a patient’s home or an assisted-living or long-term care

facility. The 12-bed Sentara Hospice House in Virginia Beach is the

only facility of its kind in Hampton Roads. Here, Sentara’s hospice

team provides full-time caregiving so that patients and loved ones

can focus on their time together.

30 30

POWER OFPREVENTIVE

Pearl Hawver believes in the power

of a positive attitude.

She also believes in the strength

of preventive care. That’s why,

every year on her birthday, she

gives herself the best gift possible

by getting a mammogram.

CARE


PEARL HAWVER

That gift paid off in January 2015, when her

routine mammogram discovered a lump in

her right breast.

“My doctor said, ‘You have breast cancer.’

And I said, ‘OK, what next?”

It’s that same direct, no-nonsense approach

Pearl used to face her diagnosis of Her2+

breast cancer. She turned to the team of

Dr. Farn Chan and Dr. Masoom Kandahari,

triple-board-certified hematology and

oncology experts.

Springing Into Action

“The mission of our team is to implement

a patient-centered environment where

patients are at the core of discussion and

decision making,” explained Dr. Kandahari,

medical staff president at Sentara Northern

Virginia Medical Center.

With Pearl’s diagnosis of Her2+ breast

cancer, the doctors were able to consult

with one another to determine the best

course of action.

“Her2+ breast cancer tends to be more

aggressive, associated with higher risk of

recurrence and poorer prognosis in the

absence of systemic therapy. However,

prognosis has improved with the availability

of Her2 targeted therapy,” said Kandahari.

Pearl’s personalized medical plan included:

six months of chemo, a lumpectomy,

receiving radiation and then following up

with a year of Her2 chemo. Her positive

attitude helped lead the way.


“Cancer is a journey and they are right there with you”

PEARL HAWVER BREAST CANCER SURVIVOR

“I did really well on chemo — I’m pretty

laid back. I don’t let anything rent space in

my head,” said Pearl. “I give it to God and

we go from there.”

Living Cancer Free

Pearl says part of the reason things went

so well was because of the support she

received from her family, especially her

younger sister, Phyllis. Phyllis, also a

breast cancer survivor, helped Pearl channel

her sewing talents to help fund breast

cancer research.

“Right now, I’m making pin cushion hats for

Relay for Life,” said Pearl, “Last year, I did

five tote bags and they went for $100 each!”

The 78-year-old is living her life to the fullest,

spending time with her three kids, five

grandchildren and five great-grandchildren,

thanks to the team approach of Dr. Chan

and Dr. Kandahari.

“Cancer is a journey and they are right

there with you,” said Pearl.

32 |

PERSONALIZED APPROACH

The future of cancer medicine relies on information about a

patient’s unique genetic makeup and the composition of his or her

specific cancer. This information is extremely helpful in selecting

the best treatments for targeting specific genes and proteins

responsible for cancer cell growth. Sentara continues to focus on

precision medicine as a means to offer a more personalized and

effective approach to cancer treatments.

MOLECULAR TESTING

In 2017, the Sentara molecular testing laboratory implemented

next-generation molecular sequencing to analyze multiple genes

faster and more cost-effectively. The test evaluates 50 genes that

are known to affect tumor growth and treatment response. Using

the results, oncologists tailor chemotherapy to target the unique

genomic makeup of a patient’s tumor.

Our on-site, board-certified molecular genetic pathologist ensures

our doctors get critical test results within one week (compared to

two to three weeks with an off-site lab). This fast turnaround allows

patients to start appropriate treatment sooner. Nine out of 12

Sentara hospitals were using the on-site lab in 2017.

Also in 2017, the lab began automatically testing for gene mutations

in patients whose lab results indicate non-small cell lung cancer.

This process allows oncologists to develop a treatment plan based

on the lab findings and have it ready when they meet with a patient

to give the diagnosis.

We continue to look to the future by preserving patients’ biopsied

tissue samples in formalin-fixed paraffin. Should a patient need

additional tests, we can use the preserved tissue instead of

conducting another biopsy. With multigene sequencing, we can

test for more gene mutations using less tissue. Researchers also

utilize archived tissue samples for use in studies.

GENETIC COUNSELING

A genetic counselor worked with a team of breast cancer

specialists at Sentara Martha Jefferson Cancer Center on

developing a high-risk breast cancer program throughout 2017,

which went into effect at the start of 2018. The program uses

information gleaned from mammogram screenings, personal

histories and questionnaires to identify women who could have a

higher risk for breast cancer. Women whose lifetime risk of breast

cancer is 20 percent or higher receive a mailed letter asking them

to contact the high risk breast program. Following another risk

assessment test via phone, appropriate patients are referred to

“In our molecular lab, we conduct testing on the DNA from each patient’s tumor and based on mutations in their specific genes, we deliver targeted therapies that are uniquely personalized.”

— Tabetha Sundin, Ph.D., Director, Sentara Molecular Lab


the program for follow-up. Blood tests

can screen for up to 46 genetic mutations

linked to breast cancer, including BRCA

1/2. The goal is to identify women who

might benefit from more frequent and/

or additional screenings such as breast

magnetic resonance imaging (MRI).

Sentara RMH Medical Center also has

a high risk breast program, and both

programs continue to work together on

best practices.

In addition to breast cancer, genetic

counselors advise patients and loved

ones who have a higher risk of hereditary

cancers such as ovarian, uterine, colorectal,

prostate and pancreatic. While genetic

tests are helpful, inherited gene mutations

are responsible for only 5 to 10 percent of

all cancers.

When needed, genetic counselors partner

with psychologists and social workers to

connect patients and family members with

appropriate counseling resources.

34

“I think of them [Sentara] as dear friends now.”

TRISHA REHPELZ UTERINE CANCER SURVIVOR

Trisha Rehpelz’s roots run deep

in Virginia Beach, and so do her

ties with Sentara Virginia Beach

General Hospital.

Trisha and her extended family consider

the Sentara Virginia Beach General Hospital

their “home” hospital. Many care providers,

NAVIGATING CANCER WITHCOMPASSION


TRISHA REHPELZ

34

including Trisha’s nurse navigator, have a

special place in her heart after Trisha, her

sister and their mom were all patients at

the hospital in the same year.

Trisha, 56, was also one of the first

patients to be treated through the Sentara

Virginia Beach General Hospital Advanced

Gynecologic Oncology program.

One Diagnosis Leads to Another

Trisha’s latest healthcare journey started

after she experienced breathing difficulty,

felt dizzy and couldn’t walk. She called

the ambulance, which took her to Sentara

Virginia Beach General Hospital.

“That’s where we’ve always gone – my

whole family,” said Trisha, who worked for

40 years at her family’s Charlie’s Seafood

Restaurant in Virginia Beach and has also

volunteered with Ocean Park rescue. “It’s

a couple miles from home, and it was

comforting to be at a familiar place. I also

transported patients there as an EMT.”

Emergency room physicians diagnosed

Trisha with a pulmonary embolism, a

sudden blockage in a lung artery caused by

a blood clot.

Trisha was hospitalized for eight days for the

embolism in April 2017. During the hospital

stay, she also mentioned abnormal vaginal

bleeding to her physicians, which they

determined to be uterine bleeding. Trisha

followed up with her gynecologist when she

was released from the hospital. A biopsy

revealed she had stage 1 uterine cancer.

Because of certain medical conditions,

Trisha waited a few months before

her hysterectomy.

Caretaker for Mom, Sister

At the same time, Trisha was also taking

care of her sister, Lizzie, who was fighting

glioblastoma, an aggressive malignant

brain tumor. Lizzie was diagnosed in March

2016 after suffering severe memory loss

and confusion.

While Lizzie was recovering at Sentara

Virginia Beach General Hospital from one of

her brain surgeries, their mother, then 85,

fell and broke her hip at home. She, too,

was admitted to the hospital, and Trisha

bounced from floor to floor to visit with

them both.

Trisha particularly remembers the kindness

of her sister’s neurosurgeon, Dr. Wylie

Zhu (Chief of Neurosurgery with Sentara

Medical Group). He would find Trisha in her

mother’s hospital room to deliver updates

about her sister.

Carol Hodies, an oncology patient navigator,

also became a trusted friend and source of

advice and guidance for Trisha and Lizzie.

“It was a pleasure to navigate both Trisha

and Lizzie,” Hodies said. “They were so

inspiring. Despite their circumstances, they

were always full of laughter and

positivity, and always interested in those

around them.”

Sister and Hospital Bonds

Lizzie valiantly and persistently battled

glioblastoma, but the aggressive cancer

kept returning. She passed away at Sentara

Hospice House in October 2017.

A month later, Trisha returned to Sentara

Virginia Beach General Hospital to complete

her cancer treatment, a total hysterectomy

with the minimally invasive da Vinci robot.

“The day I had my surgery I felt Lizzie with

me all day,” said Trisha.

Trisha credits her family, Catholic faith and

church community with giving her the

strength to cope with all she endured.

“I am blessed,” she said. “I’m doing better

on all accounts. The blood clot is gone and

the cancer is gone. I can’t thank all of our

healthcare providers enough.”


36 |

CLINICAL QUALITY & OUTCOMES

As Virginia’s first and only Integrated Network Cancer Program

(INCP) accredited by the American College of Surgeons’

Commission on Cancer, Sentara maintains a sharp focus on quality.

The Sentara Cancer Registry collects and analyzes data about

cancer incidence, tumor characteristics, staging, and survival for

our patients. This information helps drive community outreach

efforts, bolster clinical quality and improve the patient experience.

Our cancer registry also plays an important role in reporting cancer-

specific data to the Virginia Department of Health, the National

Cancer Institute and the National Cancer Database. In 2017, all

of the Sentara Cancer Network facilities migrated to the same

software platform, allowing for standardized clinical quality reports,

increased efficiencies and the ability to benchmark all of the

facilities in reference to each other.

We monitor patients for life, evaluating survival and recurrence

rates. We also analyze the patient experience, including timeliness

of care, patient satisfaction, hospital readmissions, inpatient

complications and lengths of stay. This information helps improve

processes and care. Data transparency is critical to our success, so

we publish our outcomes for all to see.

** Source: Cancer Registry; Date of Initial Diagnosis 2013 to 2015; Analytic Prostate, Kidney, and Bladder cases – All regions

KIDNEY PROSTATE URINARY BLADDER

SYSTEM UROLOGY VOLUMES**

2014

2014

2014

2015

2015

2015

2016

2016

2016

PANCREATIC RESECTION MORTALITY*

Sentara Cancer Network consistently meets or exceeds the data

presented in the Journal of the National Cancer Institute.

SENTARA CAREPLEX HOSPITAL / SENTARA LEIGH HOSPITAL / SENTARA NORFOLK GENERAL HOSPITAL / SENTARA VIRGINIA BEACH GENERAL HOSPITAL

* Source: CareDiscovery database, Sentara Decision Support; Journal of the National Cancer Institute, Assessment of Pancreatic Cancer Care in the United States Based on Formally Developed Quality Indicators

2013

JOURNAL OF THE NATIONAL CANCER INSTITUTE

2010 2011 2012 2015 20172014 2016

5%

4%

3%

2%

1%

0%

5%

700

600

500

400

300

200

100

0

37

OUR QUALITY MEASURESEvery three years, the American College of Surgeons’ Commission on Cancer surveys the Sentara Cancer Network to evaluate the effectiveness of the services provided, the utilization of multidisciplinary care, clinical quality, and the institution’s commitment to community outreach.

As part of these standards, the Commission on Cancer reviews clinical quality metrics to ensure the cancer program is in compliance and identifying any opportunities for improvement.

Multi-year performance is shown below with the US and VA data acquired from the American College of Surgeons’ National Cancer Data Base (NCDB).

20 40 60 80 100

CONFIDENCEINTERVAL

92.6-97.2

90.1-100

91.2-100

92.2-94.6

92.2-92.6

94.9% Sentara HR and NOVA Hospitals*

95.8% Sentara Martha Jefferson Hospital

97% Sentara RMH Medical Center

93.4% Virginia CoC-accredited programs

92.4% United States CoC-accredited programs

BREASTRadiation therapy is administered within 1 year of diagnosis for women under the age of 70 receiving breast conservation surgery for breast cancer.

20 40 60 80 100

CONFIDENCEINTERVAL

91.2-95.6

93.6-100

85.1-99.5

93.9-95.7

93.1-93.5



92.3% Sentara RMH Medical Center



BREAST Tamoxifen Administration — Tamoxifen or third generation aromatase inhibitor is considered or administered within 1 year of diagnosis for women with T1cN0M0, or Stage II or III hormone receptor positive breast cancer.

20 40 60 80 100

CONFIDENCEINTERVAL

86.4-100

100-100

100-100

92.1-98.3

89.7-91.1


100% Sentara Martha Jefferson Hospital




BREASTRadiation Therapy Administration Following Mastectomy — Radiation therapy is considered or administered following any mastectomy within 1 year (365 days) of diagnosis of breast cancer for women with more than 4 positive regional lymph nodes.

*Sentara Hampton Roads Hospitals and Sentara Northern Virginia Medical Center

38 | 38

20 40 60 80 100

CONFIDENCEINTERVAL

87.8-98

76.1-100

100-100

92.9-93.7

92.9-93.7




94% Virginia CoC-accredited programs


20 40 60 80 100

CONFIDENCEINTERVAL

98-99.4

93.4-99

90.8-98.2

95.4-96.6

92.6-92.8






20 40 60 80 100

CONFIDENCEINTERVAL

92.1-100

100-100

44.9-100

90.4-96.4

88.8-90






NBXImage or palpation-guided needle biopsy to the primary site is performed to establish diagnosis of breast cancer.

BREAST (CONTINUED)Combination chemotherapy is considered or administered within 4 months of diagnosis for women under 70 with T1cN0M0, or Stage II or III hormone receptor negative breast cancer.

20 40 60 80 100

CONFIDENCEINTERVAL

85.6-94.8

82.7-100

62.1-93.5

89.7-92.9

92-92.6






COLORECTALAt least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer.

COLORECTALAdjuvant chemotherapy is considered or administered within 4 months of diagnosis for patients under the age of 80 with Stage III (lymph node positive) colon cancer.



20 40 60 80 100

CONFIDENCEINTERVAL

13.8-61.2

100-100

40.5-61.9

59.5-63.3

37.5% Sentara Hampton Roads hospitals




20 40 60 80 100

CONFIDENCEINTERVAL

77.8-100

100-100

100-100

92.4-100

91.5-93.1






20 40 60 80 100

CONFIDENCEINTERVAL

92.7-100

100-100

74.1-100

92.5-97.5

92.1-93.1






20 40 60 80 100

CONFIDENCEINTERVAL

69.5-100

100-100

100-100

85.2-94.6

92.4-93.4






GASTRICAt least 15 lymph nodes are removed and pathologically examined for resected gastric cancer.

LUNGSystemic chemotherapy is administered within 4 months to day preoperatively or day of surgery to 6 months postoperatively, or it is recommended for surgically resected cases with pathologic lymph node-positive.

LUNGSurgery is not the first course of treatment for cN2, M0 lung cases.

RECTALPreoperative chemo and radiation are administered for clinical AJCC T3N0, T4N0, or Stage III; or postoperative chemo and radiation are administered within 180 days of diagnosis for clinical AJCC T1-2N0 with pathologic AJCC T3N0, T4N0, or Stage III; or treatment is recommended for patients under the age of 80 receiving resection for rectal cancer.


ACCREDITATIONS & AWARDS

SENTARA RECOGNIZED AS ONE OF AMERICA’S BEST EMPLOYERS

Sentara Healthcare has been recognized as one of the best employers in the nation — not just in

healthcare but across all industries. The recognition by Forbes is a testament to the work and commitment

of everyone within the Sentara community and is a direct reflection of how we value our team members.

We are proud to be among some of the nation’s most respected organizations and grateful to our talented

team as they live our mission to improve health every day.

TWO SENTARA HOSPITALS ON IBM WATSON HEALTH 100 TOP HOSPITALS LIST

Both Sentara Leigh Hospital and Sentara Williamsburg Regional Medical Center were recognized among

the IBM Watson 100 top hospitals by IBM Watson Health (formerly known as Truven Health Analytics).

Sentara Leigh Hospital was also included on the 2017 list and in 2018, received an additional 100 Top

Hospitals Everest Award that is given to hospitals for rate improvement over five years. They were one of

only 13 Everest Award winners.

Learn more at sentara.com/Top15

SENTARA IS ONE OF THE NATION’S TOP 15 HEALTH SYSTEMSWHY IS THIS IMPORTANT?Out of 338 health systems, Sentara is among the top 15 highest-performing health systems in the nation - the only recognized large health system on the East Coast. When compared to non-winning peers, Sentara significantly outperforms them in a number of ways:

• Fewer Complications and Infections

• Fewer In-Hospital Deaths

• Shorter Length of Stay

• Shorter Emergency Department Wait Times

• Higher Patient Satisfaction

• Lower Cost

sentara.com/BestEmployer Your community, not-for-profit health partner

To learn more, visit sentara.com/BestEmployer

Sentara Healthcare has been recognized as one of the best employers in the nation - not just

in health care but across all industries. The recognition by Forbes is a testament to the work

and commitment of everyone within the Sentara community and a direct reflection of how

we value our members of the team. We are proud to be among some of the nation’s most

respected organizations and grateful to our talented team as they live our mission to improve

health every day.

Sentara Recognized as One of America’s Best Employers

40 |


AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCER (COC)

All of the Sentara Cancer Network facilities in Hampton Roads,

as well as Sentara Northern Virginia Medical Center and Sentara

Albemarle Medical Center, are accredited by the CoC. The Sentara

Cancer Network in Hampton Roads, Northeastern North Carolina

and Northern Virginia remain the only accredited Integrated Cancer

Network Program in Virginia. Sentara Martha Jefferson Hospital

(SMJH) and Sentara RMH Medical Center are both accredited

separately as Comprehensive Community Cancer Programs.

FOUNDATION FOR THE ACCREDITATION OF CELLULAR THERAPY (FACT)

The autologous stem cell transplant program at Virginia Oncology

Associates at Sentara Norfolk General Hospital remains the only

one in Hampton Roads to receive FACT accreditation. The program

adheres to stringent clinical standards and meets the gold

standard requirements insurance companies often demand.

NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS (NAPBC)

All Sentara Comprehensive Breast Centers continue to be

fully accredited by the NAPBC. The NAPBC has established 28

program standards and 17 program components of care that

breast centers must meet to ensure patients with breast disease

receive the highest level of care. Evidence-based standards include

breast center leadership, clinical management, research, quality

improvement, community outreach and professional education.

AMERICAN COLLEGE OF RADIATION ONCOLOGY (ACRO)

All Sentara Cancer Network radiation therapy centers in Hampton

Roads, Northeastern North Carolina, Halifax and Northern Virginia

are fully accredited by ACRO. Sentara RMH Medical Center is

accredited by the American College of Radiology. This voluntary

accreditation process ensures facilities follow practice standards

set by professional peers.

ADDITIONAL ACCREDITATIONS AND HONORS

American College of Radiology accreditation

College of American Pathologists (CAP) accreditation

American Society of Clinical Oncology Quality

Oncology Practice Initiative Certificate of Participation

SRC Center of Excellence for Minimally Invasive Gynecology

and Robotic Surgery (Sentara Virginia Beach General Hospital)

42 |

RESEARCH AND SCHOLARLY ACTIVITY

PUBLICATIONS

Bulzan J, Revels J, Byun K. Progression of multiple myeloma detected on cardiac scinigraphy with 99mTc Sestamibi. Clinical

Nuclear Medicine. Volume 43, Issue 7, July 2018, Pages 497-498. PMID: 29742603

Aggarwal V, Chuprin A, Aggarwal A, Vingan H, Crandley E. Bleeding after interstitial brachytherapy for cervical cancer requiring embolization. Radiology Case Reports. Volume 13, Issue 6, December 2018, Pages 1141-1145. PMID: 30233746

Reese J, Chebolu A, Shen Y, Mihlon F. Case Report: Diffuse metastatic infiltration of the thyroid by esophageal adenocarcinoma mimicking non-neoplastic thyroid disease.Radiology Case Reports. Volume 13, Issue 1, February 2018, Pages 108-111. PMID: 29487644

O’Neal D, Cohen T, Peterson C, Barr RG. (2018). Contrast-Enhanced Ultrasound-Guided Radiofrequency Ablation of Renal Tumors. Journal of Kidney Cancer and VHL, 5(1), 7–14

Reese J, Apoorv C, Mihlon F. Diffuse infiltration of the thyroid gland by metastatic esophageal adenocarcinoma, a previously undescribed pattern and important mimic of non-neoplastic thyroid disease. Radiology Case Reports, 12/2017 PMID: 29487644

Wade G, Revels J, Hartman L, Brown W. Pediatric Mandibular Metastasis: A rare finding of neuroblastoma. Radiology Case Reports. 10/2017 PMID: 29552266

Wallace J, Krupa M, Brennan J, Mihlon F. Ipilimumab cystic hypophysitis mimicking metastatic melanoma. Radiology Case Reports.

2018 May 21; 13(3): 740-742 PMID: 29977435

Kim S, Plemmons J, Hoang K, Chaudhuri D, Kelley A, Cunningham T, Hoefer R. Breast-specific Gamma Imaging versus Breast MRI: Comparing the Diagnostic Performance in the Assessment of Treatment Response following Neoadjuvant Chemotherapy in Breast Cancer Patients. American Journal of Radiology

(AJR), accepted.

Azab B, Amundson JR, Picado O, Ripat C, Macedo FI, Franceschi D, Livingstone AS, Yakoub D. [2018; Epub ahead of print] Impact of Chemoradiation-to-Surgery Interval on Pathological Complete Response and Short- and Long-Term Overall Survival in Esophageal Cancer Patients. Ann Surg Oncol. 2018 Oct 11. doi: 10.1245/s10434-018-6897-4. PMID:30311162

Azab B, Macedo F, Cass S, Ripat C, Razi S, Picado O, Franceschi D, Livingstone A, Yakoub B (2018, in press). A Large National Comparative Study of Clinicopathological Features and Long-Term Survivals between Esophageal Gastrointestinal Stromal Tumor and Leiomyosarcoma. The American Journal of Surgery, DOI:https://doi.org/10.1016/j.amjsurg.2018.10.046

Thomas T, Small W, Fleming M, Kang S & Hoefer R (2018). Interoperative Radiation “Boost” to the Surgical Resection Bed following Pancreaticoduodenectomy for a Borderline Resectable Pancreatic Carcinoma: A Case Report. Frontiers in Oncology, 8:12. doi: 10.3389/fonc.2018.00012

Kang S, Jones H, Velasco C, Obiora C, Miller M, & Hoefer R (2018). Skin Toxicity Following Interoperative Partial Breast Irradiation Using


Low-Kilovoltage X-Rays. Poster presented at the

Targit Collaborative Group Conference, Las Vegas, April 2018.

Vinik A, Hughes M, Feliberti E, Perry R, Casellini C, Sinesi M, Vingan H, and Johnson L. (updated 2018). Carcinoid Tumors. In: De Groot LJ, Chrousos G, Dungan K, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.;

2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279162/

Lavingia K, Torabi R, Kim S, Hughes M, Feliberti E, and Perry R, A Rare Adrenal Incidentaloma That Mimics Adrenocortical Carcinoma, Case

Reports in Surgery, vol. 2018, Article ID 9607972, 4 pages, 2018. https://doi.org/10.1155/2018/9607972.

Fisher G, Wolin E, Liyanage N, Lowenthal S, Mirakhur B, Pommier R, Shaheen M, & Vinik A (2018). Patient‐Reported Symptom Control of Diarrhea and Flushing in Patients with Neuroendocrine Tumors Treated with Lanreotide Depot/Autogel: Results from a Randomized, Placebo‐Controlled, Double‐Blind and 32‐Week Open‐Label Study. The Oncologist, 23(10), 16-24.

ABSTRACTS, POSTERS AND ORAL PRESENTATIONS, EDUCATIONAL EXHIBITS

Vogler JB, Revels J, Wang SS, Lazarow F, Johnson LS, Kolokythas O, Imaging of Lymphedema: A Primer for Radiology Residents. RSNA Presentation, 104th Scientific Assembly and Annual Meeting; Chicago, IL (2018).

Andrews RH, Vogler JB, Plemmons J, Elzie CA, Goodmurphy C, Trace AP. Simulation-based Ultrasound-guided breast biopsy training improves operator knowledge, accuracy, and confidence. Society of Interventional Radiology (SIR) Annual Meeting, Los Angeles, CA, March 2018. (oral presentation)

Reese J, Milhon F, Sellar and supresellar tumors: but not what you think! American Society of Neuroradiology 2018 Annual meeting, Vancouver, Canada (poster & electronic presentation).

Bridenstine J, Andrews R, Vogler J, Plemmons J, Elzie, CA, Goodmurphy C, Trace A. Simulation-based US-guided breast biopsy training improves operator knowledge, accuracy and confidence. October 2018 EVMS Research Day

More academic publications are available online at SentaraCancerData.com.

44




2016 SENTARA CANCER NETWORK

PRIMARY SITE TABLESWe collect data on cases diagnosed and treated at each facility in our network. Analytic cases are cases diagnosed and/or treated during the first course of treatment at the assigned institution. Please note that the sum of the individual facilities may not add up as some cases are shared among multiple facilities, which affects the totals.

This table’s data is collected by the Sentara Cancer Network Registry Subcommittee from the Hampton Roads region and other regional registrars.

CANCER REGISTRARS Sentara Albemarle Medical CenterNannette Jones, CTR Sentara Martha Jefferson HospitalMaria Barnes, CTRRebecca Lewis, CTRJessica Washington, CTR Sentara RMH Medical CenterApril Bowles, CTR Eunice Wiens, CTR Hampton RoadsTammy Berryhill, CTR Karrie Brickhouse CTRKristy Bridgeman, CTRDiana Coates, CTR Rhonda Despinis, CTR Cynthia Freeman, CTRHolanda HardingJune HarlowMarlene Kelly, CTRKathleen Marcia, CTR Michelle Morse-Buszard Cressetta Peterson, CTR Terry ReichMary Seemueller, CTRLana Tyree, CTR

Grouping Primary Site Total Analytic Total Analytic Total AnalyticHead/Neck Lip 0 0 0 0 0 0

Tongue 13 13 2 2 76 65Salivary Gland 2 2 0 0 13 13Floor of Mouth 0 0 0 0 13 12Gum/Other Mouth 2 2 0 0 24 21Nasopharynx 2 1 1 1 8 7Tonsil 10 10 3 1 47 36Oropharynx 2 2 0 0 5 2Hypopharynx 0 0 0 0 5 5Other Oral Cavity and Pharynx 0 0 0 0 0 0

Digestive Esophagus 17 13 13 11 10 7Stomach 12 10 17 16 23 22Small Intestine 6 6 10 10 13 12Colon 44 44 51 50 65 56Rectosigmoid Junction 1 1 0 0 5 3Rectum 17 17 15 14 15 12Anus, Anal Canal, and Anorectum 5 5 9 7 9 8Liver 6 6 12 11 20 17Intrahepatic Bile Duct 2 2 2 2 3 3Gallbladder 3 3 5 5 2 0Other Biliary 0 0 8 6 16 16Pancreas 25 22 24 23 69 64Retroperitoneum 0 0 0 0 2 1Peritoneum, Omentum, and Mesentery 1 1 2 2 0 0Other Digestive Organs 1 1 3 2 4 3

Respiratory Nose, Nasal Cavity and Middle Ear 2 2 0 0 6 4Larynx 18 17 2 2 42 37Lung, Bronchus - Small Cell 15 12 13 11 29 20Lung, Bronchus - Non Small Cell 109 100 154 124 282 245Lung, Bronchus - Other Types 5 4 7 6 24 20Pleura 0 0 0 0 0 0Trachea, Mediastinum, Other Respiratory 0 0 0 0 0 0

Bones and Joints Bones and Joints 0 0 0 0 2 2Soft Tissue Including Heart Soft Tissue Including Heart 8 7 8 6 24 23Skin Excl Basal and Squamous Melanoma - Skin 137 135 9 8 159 133

Other Rare Skin Types 9 8 0 0 9 8Breast Breast 250 243 367 360 381 276Female Genital System Cervix 5 5 7 6 7 2

Uterus 11 9 50 44 33 15Ovary 5 4 18 17 6 5Vagina 0 0 2 1 2 1Vulva 3 3 13 6 6 2Other Female Genital Organs 0 0 1 1 0 0

Male Genital System Prostate 77 62 16 13 168 143Testis 4 3 1 1 13 11Penis 3 1 0 0 4 4Other Male Genital Organs 0 0 0 0 0 0

Urinary System Bladder 30 29 29 22 134 118Kidney/Renal Pelvis 18 15 12 5 226 214Ureter 1 1 0 0 10 7Other Urinary Organs 0 0 3 3 7 7

Eye and Orbit Eye and Orbit 0 0 0 0 2 2Brain and Other CNS Brain 10 10 5 5 85 80

Other CNS 0 0 0 0 0 0Endocrine Thyroid 17 16 21 20 85 81

Other Endocrine, Thymus 2 2 2 2 21 18Lymphoma Hodgkin Lymphoma 3 2 2 2 14 10

Non-Hodgkin Lymphoma 36 34 32 27 81 44Myeloma 5 4 13 10 35 11

Leukemia Leukemia 6 5 15 11 79 25Mesothelioma/Kaposi Sarcoma Mesothelioma 3 3 5 5 3 1

Kaposi Sarcoma 0 0 1 0 2 1Miscellaneous Miscellaneous 13 12 15 11 74 25

TOTAL 976 909 1000 892 2502 1980

HAMPTON ROADS





Sentara Cancer Network Total Caseload

Sentara Cancer Network Total Analytic Caseload

Total Analytic Total Analytic Total Analytic Total Analytic Total Analytic Total Analytic Total Analytic Total Analytic Total Analytic0 0 0 0 1 1 0 0 3 3 1 1 0 0 0 0 5 50 0 2 2 7 2 8 6 8 7 12 10 1 1 4 4 123 1040 0 0 0 3 2 0 0 3 3 0 0 0 0 3 3 23 220 0 0 0 0 0 0 0 0 0 3 2 1 1 0 0 17 150 0 0 0 2 1 0 0 0 0 1 1 2 1 1 1 30 252 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 15 101 1 1 1 10 8 4 3 3 2 3 2 1 1 0 0 68 520 0 1 1 1 1 0 0 1 1 1 1 0 0 0 0 9 60 0 1 0 2 2 0 0 0 0 0 0 0 0 0 0 7 60 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 2 112 11 8 6 7 6 6 4 16 16 13 11 6 6 3 2 101 847 7 8 7 19 18 6 6 12 9 16 11 5 5 12 10 125 1094 3 8 7 8 8 2 2 4 4 3 3 2 2 1 1 52 49

33 32 33 32 88 82 18 16 59 52 69 54 21 20 33 33 490 4492 2 0 0 8 8 0 0 4 2 3 2 2 2 7 6 32 2614 13 10 10 33 32 7 7 19 18 28 18 15 15 6 4 168 1492 2 0 0 6 3 0 0 5 5 7 5 3 2 6 6 48 393 2 2 1 7 7 3 2 6 6 5 5 4 2 3 3 62 541 0 0 0 3 3 1 1 3 3 1 1 1 1 0 0 17 161 1 0 0 1 1 1 1 3 0 1 1 2 2 3 3 20 154 3 6 5 13 12 2 2 2 2 0 0 0 0 0 0 41 3713 10 12 7 36 31 12 11 28 26 22 20 8 8 6 5 226 1990 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 4 32 2 1 1 4 2 1 1 3 3 0 0 0 0 0 0 12 104 4 3 3 10 9 3 2 2 2 1 1 0 0 0 0 30 261 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 9 63 3 2 2 8 7 4 3 2 2 8 8 5 5 3 3 84 7713 13 12 10 15 12 5 2 20 18 8 8 15 14 11 9 149 12573 68 53 40 116 96 22 14 110 103 92 91 44 42 34 32 983 8587 7 4 3 6 6 0 0 4 4 6 6 6 6 5 5 70 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 2 1 0 0 1 1 2 1 0 0 0 0 7 51 1 4 2 7 5 1 0 5 5 4 3 2 2 1 1 60 50

25 21 27 8 85 53 14 7 79 68 38 30 7 3 3 3 572 4641 1 2 0 11 11 2 1 3 3 3 1 1 0 1 1 39 31

145 144 186 180 263 220 139 136 154 150 253 251 87 71 144 136 2117 19227 7 1 1 11 8 1 1 4 2 3 2 1 1 4 4 44 3419 19 2 0 98 94 5 4 28 21 23 15 8 8 14 13 254 2098 7 8 8 19 17 1 1 10 8 2 2 3 3 4 3 74 651 1 0 0 2 1 0 0 0 0 1 0 0 0 1 1 6 31 1 0 0 6 2 0 0 7 1 5 0 2 2 0 0 38 141 1 1 1 6 6 1 1 1 1 0 0 0 0 0 0 9 9

34 25 6 5 73 58 7 6 81 75 75 61 59 58 82 75 671 5741 1 4 4 6 4 1 1 3 3 2 2 0 0 2 2 35 311 1 0 0 0 0 1 1 1 1 0 0 1 1 1 1 10 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 07 6 14 12 52 46 28 23 46 45 26 25 18 18 34 33 389 3498 7 13 10 24 22 5 4 30 30 12 11 15 14 21 21 362 3320 0 0 0 2 1 0 0 6 6 0 0 3 2 1 1 22 170 0 0 0 2 1 0 0 3 3 1 1 0 0 0 0 16 150 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 3 27 7 8 8 19 19 1 1 9 9 4 4 23 20 8 7 152 1440 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 19 9 6 5 18 16 7 7 14 14 21 21 3 3 10 10 190 1811 1 2 2 1 1 1 1 1 1 0 0 2 2 0 0 26 231 1 0 0 10 8 4 4 4 4 1 1 1 1 4 3 42 35

31 28 33 28 43 32 15 13 30 29 34 33 7 6 17 16 329 2679 8 5 3 10 9 2 0 19 19 18 18 4 3 14 11 125 9315 14 10 10 19 13 5 3 33 33 30 30 0 0 1 1 202 1394 4 1 1 4 4 0 0 4 4 1 1 0 0 0 0 23 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 114 14 4 4 7 6 10 9 30 30 22 20 7 7 14 13 205 146

553 514 504 430 1217 1019 359 308 926 857 888 798 398 361 522 486 9048 7825

HAMPTON ROADS HAMPTON ROADS BLUE RIDGENORTHCAROLINA

NORTHERNVIRGINIA





46 |

SENTARA CANCER NETWORK LEADERSHIP TEAM We work to attract and retain some of the country’s leading cancer experts in hopes that they will further develop our network into one of the top-performing treatment collaborations in the world. Our team as of fall 2018 includes:

PHYSICIANSThomas Alberico, M.D. Medical Oncology, Sentara Virginia Beach General Hospital Oncology High Performance Team (HPT) Chair, Sentara Cancer Network

Christina Alencar, M.D. Medical Oncology, Sentara Albemarle Medical Center

Daniel Atienza, M.D. Medical Oncology, Sentara Obici Hospital

Parag Bharadwaj, M.D. Palliative Care, Sentara Princess Anne Hospital

Kathy Byun, M.D. Radiology, Sentara Norfolk General Hospital

Farn Chan, M.D. Medical Oncology, Sentara Northern Virginia Medical Center

Edwin Crandley, M.D. Radiation Oncology, Sentara Norfolk General Hospital

Eric Feliberti, M.D. Surgical Oncology, Sentara Norfolk General Hospital

Mark Fleming, M.D. Medical Oncology, Sentara CarePlex Hospital

Sylvia Hendrix, M.D. Radiation Oncology, Sentara Martha Jefferson Hospital

Richard Hoefer, D.O. Surgical Oncology, Sentara CarePlex Hospital Cancer Conference Coordinator

Marybeth Hughes, M.D. Surgical Oncology, Sentara Norfolk General Hospital

Donald Jenkins, M.D. General Surgery, Sentara Virginia Beach General Hospital and Sentara Princess Anne Hospital

Lester Johnson, M.D. Radiology, Sentara Norfolk General Hospital

Ghana Kang, M.D. Medical Oncology, Sentara Northern Virginia Medical Center

Eric Lappinen, M.D. Radiation Oncology, Sentara Norfolk General Hospital

Ying Li, M.D. Palliative Care, Sentara Leigh Hospital

Janete Mills, M.D. Radiation Oncology, Sentara Albemarle Medical Center

Heather Morgan, M.D. Radiation Oncology, Sentara RMH Medical Center

Diana Padgett, M.D. Pathology, Sentara RMH Medical Center

John Paschold, M.D. Medical Oncology, Sentara Williamsburg Regional Medical Center

Dennis Rowley, M.D. Pathology, Sentara Norfolk General Hospital

William Rudolph, M.D. Colorectal Surgery, Sentara Virginia Beach General Hospital

John Sayles, M.D. Colorectal Surgery, Sentara Leigh Hospital

Neil Schacht, M.D. Medical Oncology, Sentara Halifax Regional Hospital

James Schneider, M.D. Surgical Oncology, Sentara Leigh Hospital Cancer Liaison Physician

Cynthia Sile, M.D. Medical Oncology, Sentara Obici Hospital

Marc Silverberg, M.D. Pathology, Sentara Norfolk General Hospital

Christopher Willms, M.D. Thoracic Surgery, Sentara Martha Jefferson Hospital

ADMINISTRATIVE AND CLINICAL LEADERSHIPCindy Allen, VP VP Oncology Service Line, Sentara Corporate

Heidi Ambrose Radiology Director, Sentara Albemarle Medical Center

Jan Bennett ACS Representative

Ron Bieszczad Oncology Director, Sentara CarePlex Hospital

Sharon Bunn Oncology Nursing Manager, Sentara Williamsburg Regional Medical Center

Connie Bush Community Outreach, Sentara CarePlex Hospital Community Outreach Coordinator

Elana Campbell Licensed Clinical Social Worker, Sentara Norfolk General Hospital

Heather Causseaux Oncology Director, Sentara Northern Virginia Medical Center

Carolyn Carpenter President, Sentara Norfolk General Hospital

Amanda Colley Oncology Director, Sentara Virginia Beach General Hospital

Abby Dalton Oncology Nursing Manager, Sentara Virginia Beach General Hospital

Rhonda Despinis Team Coordinator, Cancer Registry, Sentara CarePlex Hospital


Nicky Dozier US Oncology Research Clinical Coordinator, Virginia Oncology Associates

Toni Erskine Oncology Nurse Specialist, Sentara Norfolk General Hospital

Mandy Gensimore Oncology Nursing Director, Sentara Northern Virginia Medical Center

Beth Gerstein Manager, Clinical Nutrition, Sentara Norfolk General Hospital

Michelle Gibson Oncology Nurse Practitioner, Sentara Halifax Regional Hospital

Caci Gilden Manager, Rehabilitation, Sentara Therapy Center - Hilltop

Audrey Gregory Genetic Counselor, Sentara Leigh Hospital

Cindy Hardy Pastoral Care, Sentara Northern Virginia Medical Center

Megan Heisse Hospice Manager, Sentara Hospice

Chernelle Hill Oncology Director, Sentara Leigh Hospital

Carol Hodies Oncology Nurse Navigator, Sentara Virginia Beach General Hospital

Jon Horton Pharmacy, Sentara Norfolk General Hospital

James Hoy Pastoral Care, Sentara Norfolk General Hospital

Yvonne Jarrels Nurse Educator, Sentara RMH Medical Center

Susan Karch Oncology Nursing Manager, Sentara Leigh Hospital

Samantha Kern Oncology Director, Sentara Princess Anne Hospital

Brad Kirby Oncology Service Line Director, Sentara Corporate Quality Improvement Coordinator

Sheri Knecht Oncology Dietitian, Sentara Norfolk General Hospital

Shannon Kriz Radiation Services Manager, Virginia Oncology Associates

Tifany Lewis Genetic Counselor, Virginia Oncology Associates

Helen Linton Business Development, Sentara Northern Virginia Medical Center

Chris Manetz Radiology Director, Sentara Princess Anne Hospital

Kathleen Marcia Team Coordinator, Cancer Registry, Sentara Virginia Beach General Hospital Cancer Registry Quality Control Coordinator

Jennifer May Clinical Research Manager, Sentara Norfolk General Hospital Clinical Research Coordinator

Maureen McGrath Executive Director, US Oncology, Virginia Oncology Associates

Rebecca Mott Hospice Director, Sentara Hospice

Lindsay Rushing Oncology Nurse Navigator, Sentara Princess Anne Hospital

Faye Satterly Oncology Director, Sentara Martha Jefferson Hospital, Sentara RMH Medical Center

Terri Sim Oncology Director, Sentara Williamsburg Regional Medical Center

Annya Soucy Oncology Service Line Leader, Sentara Albemarle Medical Center

Meredith Strand Oncology Director, Sentara Norfolk General Hospital

Becca Straseskie Team Coordinator, Rehab, Sentara Princess Anne Hospital

Grey Watson Oncology Director, Sentara Halifax Regional Hospital

Lynne Whitlock Oncology Director, Sentara Obici Hospital

Elisa Wills ACS Representative

Karen Woodhouse Licensed Clinical Social Worker, Sentara Norfolk General Hospital Psychosocial Services Coordinator

SENTARA HEALTHCARE CORPORATE LEADERSHIP AND SUPPORT Brian Boland Process Improvement

Jenna Curnes Customer Development and Marketing

Leo Deleon Finance

Terrie Edwards Corporate Vice President

Roland McLendon Decision Support

Patrick Prophet Process Improvement

Betsy Reilly Strategy

Kelsea Smith Brand Engagement

Chelsie Williams Customer Development and Marketing

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