Cancer Program Annual Report 2013

FEATURE: Lung Cancer Update

Randall Lanier, M.D., Pulmonologist

Lung cancer is a largely preventable medical condition. It is the most common cancer mortality in both men and women in the world. It is estimated in 2014 more than 224,000 cases will develop and have more than 159,000 deaths. This accounts for more deaths than the three most common cancer cases of colon, breast, and prostate combined. Lung cancer represents approximately 27 percent of all US cancer deaths. Lung cancer will be the largest cancer “killer” over the next 30 years. Twice as many people will be living with lung cancer in 2040 than in 2010. This is mainly due to longer life spans and cancer being more common as we age.

Fortunately for us, lung cancer death rates have begun to decline. Risk factors have not changed much over the years. Smoking is present in 90 percent of all lung cancers diagnosed. Other lung cancer risk factors include radiation, genetics, diet, HIV infection, emphysema, scarring of the lungs, and environmental toxins. Toxins include second hand smoke, asbestos, dust exposure, and radon which is radioactive gas produced by decay of uranium in soil.

Kentucky had the highest lung cancer death rate of any state in 2013. Kentucky also has the highest per capita tobacco use in the United States. Tobacco smoking is responsible for nearly 1 in 5 deaths in general. The smoking rate in the U.S. has dropped by half from 1965 to 2012. At the height of adult U.S. smoking, it was estimated that 42 percent of the population smoked. Now that estimate has dropped to 18.1 percent. However, in developing countries, tobacco consumption is rising at 3.4 percent per year as of 2002. Young adults are the most likely to start smoking with new onset of older smokers showing a marked decline.

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Electronic Medical Record

In May 2013, the Radiation Oncology department upgraded their EMR platform to ARIA 11, an oncology-specific electronic medical record. The enhancement has led to on-demand access to oncology specific patient information and images which has streamlined clinical workflow throughout the Radiation Oncology department.

SPECT/CT in Nuclear Medicine

In December 2013, the Nuclear Medicine Department installed the Infinia Hawkeye 4 SPECT/CT camera. This unit provides many enhancements that offer improved image resolution compared to the older generation Millenium camera that it replaced.


Physician Reviewer:
Tage Haase, M.D.,
General Surgeon

Evaluation and Treatment of Breast Cancer Patients

The Medical Center is dedicated to maintaining and enhancing the quality of cancer care we provide. In 2013, Dr. Tage Haase completed a study to examine the evaluation and treatment of breast cancer patients at The Medical Center and ensure that it is compliant with National Comprehensive Care Network (NCCN) evidence-based national guidelines: "Mastectomy versus Lumpectomy in a Community Hospital Setting."

Rationale: Patients with breast cancer have the opportunity to choose between total removal of a breast (mastectomy) and breast conserving surgery (lumpectomy) followed by radiation. Lumpectomy followed by radiation is likely to be equally as effective as mastectomy for patients with only one site of cancer in the breast and a tumor under 4 centimeters.

Study Period: 2011 (NCDB data) & 2012 (The Medical Center Registry data)

Population: Breast cancer patients at The Medical Center with clinical Stage IA treated with a lumpectomy or mastectomy.

Analysis Method: Utilizing Cancer Registry database, National Cancer Data Base and hospital medical records.

Summary: The study included a total of 33 Stage IA Breast Cancer Patients. Of those 33 patients, 13 (39 percent) received mastectomies as their overall treatment. The other 20 patients (61 percent) received lumpectomies along with 13 receiving radiation, 3 chemotherapy, 11 hormone therapy, 3 mastectomies, and 2 receiving no treatment. (Note: some of these treatments were combined.)

After looking at The Medical Center’s data for 2012, the most recent 2011 data in NCDB was compared to other Comprehensive Community Cancer Program hospitals in all states. The 2011 NCDB data showed that 66.7 percent of patients had lumpectomies and 30.2 percent of patients had mastectomies. Based upon the compared data, patients in other states are choosing more conservative based surgeries as they are at The Medical Center.

Recommendation: Based upon this study, The Medical Center’s data shows that patients receiving treatment at other Comprehensive Community Cancer Program hospitals is comparative to ours. Patients are making about the same decisions based upon their stage and information given to them by their physicians about their treatment options of lumpectomy versus mastectomy. Therefore there are no recommendations at this time. This study shows that the treatment is based upon the patient’s choice.


The Medical Center
Cancer Treatment Center for Southern Kentucky
250 Park Street
Bowling Green, KY 42101

(270) 781-7178 or 1-800-745-1213
Cancer Registry (270) 745-1288

Barren River Regional Cancer Center
103 Trista Lane
Glasgow, KY 42141

(270) 651-2478 or 1-877-573-0050