Cancer Program Annual Report 2015

FEATURE: Colorectal Cancer

Jamie Jarboe, M.D.

Colorectal cancer is the third most commonly diagnosed cancer in the United States (excluding non-melanoma skin cancer) and is the third leading cause of cancer deaths. According to the American Cancer Society and the SEER database, around 4-5% of men and women will be diagnosed with colorectal cancer in his or her lifetime. Colorectal cancer accounts for 8% of all new cancer diagnoses and about 8% of all cancer deaths as well.

The Surveillance, Epidemiology and End Results (SEER)-Medicare database estimates that 65% of patients with colorectal cancer will survive to five years. Outcomes are, of course, better in patients with early stage disease. The American Cancer Society estimates that 87-92% of patients with Stage I colorectal cancer will live to five years after diagnosis. For stage two the percentage is 80-87%, 84-89% for Stage IIIA, 69-71% for Stage IIIB and 53-58% of patients with stage IIIC disease. Those patients with metastatic disease will make it to five years post-diagnosis in only about 11-12% of the cases. The death rate for colorectal cancer has been decreasing for the last few decades across the country. There does, however, remain areas of the country (and Kentucky included) that remain hot spots for the disease with increased levels of mortality. Correlating with increased mortality is often a finding of decreased screening. One such hot spot was identified in 2015 in west central Appalachia which includes Eastern Kentucky.

Colorectal Cancer in Kentucky

Based upon the most recent published data colorectal cancer represents the second most common malignancy in Kentucky behind only lung cancer. In 2001 Kentucky ranked 50th in colorectal cancer screening with a dismal screening rate of 34.7%. The state was able to increase the screening rate into the 65% range with an improvement in ranking to 23 over 10 years from 2001-2011. This resulted in a 16% decreased incidence and mortality of colorectal cancer.

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Click circles below to see 2015 statistics on Colorectal Cancer.


In April 2015 The Medical Center appointed a dedicated oncology patient navigator to provide assistance to a cancer patient's journey through the treatment process. The navigator assists patients by removing barriers that could cause a delay in timely treatment. Patient navigation adds an individualized approach to cancer care. The relationship and trust developed by the navigator early on in a cancer patient's journey adds to the overall satisfaction of care delivered. The navigator continues to follow the patient through treatment and into survivorship. At the completion of a curative course of radiotherapy, a survivorship care plan is delivered by the navigator. The implementation of an oncology navigation program is a significant enhancement to the overall cancer care provided by The Medical Center.

In 2015, the number of lung screenings increased with more education, marketing, and coverage by insurance as CMS released codes for this procedure. There have been 29 elective low dose lung screenings performed in Bowling Green, Scottsville and Franklin. Marketing efforts have started to promote the screening in our community. We hope to see an increase in numbers next year and will continue to monitor our progress.

In 2015, The Medical Center opened a new 4D Neurosurgical Unit. The Medical Center has the most advanced brain and spine tumor program in Southern Kentucky. Neuro-oncology is a focused specialty concerning the diagnosis and treatment of brain and spine cancer and other tumors of the central and peripheral nervous system.



Physician Reviewer:
Vidya Seshadri, M.D.,
Medical Oncology

Evaluation of neurotoxicity in inpatients who receive Ifosfamide and Cytarabine: a quality control study.

The purpose of the study was to evaluate the central nervous system side effects of chemotherapy. The study was designed in our oncology inpatient unit. We planned to evaluate quality of patient care, in the patient setting. Using the stroke protocol for neurotoxicity evaluation, we designed a daily evaluation including signatures. We recognized patients who received Ifosfamide and Cytarabine. These were patients who had either acute myelogenous leukemia or recurrent refractory non-Hodgkin’s lymphoma.


We identified 10 patients with Ifosfamide and 6 patients with Cytarabine for high dose therapy. None of the patients had any adverse events (0%).

Data Sources:

Medical records access via Meditech.


Neurological side effects are common from chemotherapy. Despite peripheral neurological damage that can occur, the central nervous system toxicity has to be managed significantly and quickly. Therefore, early detection and recognition of symptoms are vital. The major medication in addition to the monocolonal antibodies are vinca alkylating agents.  These agents were monitored and the outcome documented as a quality improvement method.



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