Year in Review
A Year in Review: Memorial Hermann Cancer Centers’ 2016 Accomplishments
Letter from the Chairman
As Chairman of Memorial Hermann’s Integrated Network Cancer Committee, I am pleased to present our 2016 Oncology Annual Report. The American College of Surgeons Commission on Cancer (CoC) has approximately 1,500 accredited hospitals in the United States and Puerto Rico, which represent only 30 percent of all healthcare institutions.
Approximately 70 percent of all newly diagnosed cancers are seen at these accredited institutions. The CoC accreditation demonstrates Memorial Hermann’s commitment to high-quality
cancer care with concerted efforts and resources that span from prevention to survivorship and end-of-life care.
The Cancer Program at Memorial Hermann continues to grow and 2016 was an active year. Some of the accomplishments included:
- Successful three-year Commission on Cancer reaccreditation with silver commendation;
- Successful reaccreditation from the National Accreditation Program of Breast Centers at Greater Heights;
- Publication of the Cancer Journal highlighting the oncology program at Memorial Hermann Health System;
- Expanded oncology services with TIRR Memorial Hermann with new prehabilitative services, genetic services with UT, and community outreach screening and prevention program collaboration with local businesses;
- Robust enrollment of patients into oncology-related clinical trials;
- Growth in oncology volume year over year.
Our Cancer Program would not be successful without the support and enthusiasm of all the physicians, oncology nurses, and administrative staff who have graciously offered their time and talent to providing the best in cancer care.
Emily Robinson, M.D.
Chairman, Integrated Network Cancer Committee
Chairman, Texas Medical Center Cancer Committee
Letter from the Cancer Liaison Physician
The Memorial Hermann Health System is dedicated to providing outstanding care for cancer patients.
We are accredited by two national organizations – the Commission on Cancer (CoC) and the National Accreditation Program of Breast Centers (NAPBC) – which underscores our commitment to the highest standards for comprehensive cancer care.
As the Cancer Liaison Physician (CLP) for Memorial Hermann Greater Heights and the Integrated Network Cancer Committee as a whole, my role is to monitor, interpret and provide updated reports of the program’s performance using the National Cancer Database (NCDB) with the intent of evaluating and improving the quality of patient care. Table 1 illustrates the exceptional oncology care that is provided within our Network. The liaison serves as the link between the hospital and the community, between national treatment standards and the hospital, and between the Cancer Committee and the various departments at Memorial Hermann. In disseminating data for the CoC quality measures, the end result is enabling discussion regarding best practices, evaluating compliance with national guidelines, encouraging participation in clinical trials and improving overall quality of care.
Mike Ratliff, M.D., F.A.C.S.
CLP, Integrated Network
Cancer Committee CLP, Memorial Hermann Greater Heights
By the Numbers
Cancer Research at Memorial Hermann
Cancer is a constellation of more than 200 diseases, each of which requires a different treatment approach, underscoring the importance of translational research that implements a bench-to-bedside approach. From laboratory experiments through clinical trials to point-of-care patient applications, physician researchers affiliated with Memorial Hermann and McGovern Medical School at UTHealth are gathering knowledge that will result in new drugs, devices and treatment options for patients.
“In the last decade, clinicians and researchers at Memorial Hermann and UTHealth have moved from the sidelines to the frontlines of cancer research, with a more than hundredfold increase in oncology studies,” says Cheryl Chanaud, Ph.D., CCRP, vice president of clinical research for the Memorial Hermann Health System. “Our driving force is providing the best patient care and experience in a changing healthcare environment. The role of clinical research remains vitally important to the future of medicine. Our goal is to foster an environment supportive of innovative, high-quality research.”
Dr. Chanaud leads the Clinical Innovation & Research Institute (CIRI), which facilitates collaborative relationships between Memorial Hermann Health System, McGovern Medical School, private practice clinics and the community. CIRI fosters partnerships between clinicians, academicians, industry and public sectors to conduct and produce meaningful, quality research that benefits society. The Institute also serves as an advocate for study participants by creating an environment that supports good clinical practice in research.
Today, Memorial Hermann is the site for 141 active oncology research studies involving 3,788 patients. That number includes interventional clinical trials, registry studies that track outcomes, and tissue repository studies focused on the discovery of biomarkers that can predict clinical outcomes across a variety of treatments and patient populations.
Among the trials under way are three led by Robert J. Amato, D.O., professor for the division of Oncology at McGovern Medical School and chief of the division of Oncology at Memorial Hermann Cancer Center-Texas Medical Center.
The trials are designed to enumerate circulating tumor cells (CTCs) from whole blood in patients with genitourinary cancers – either prostate, bladder or kidney – using two systems that provide single-cell analysis of CTCs to examine tumor heterogeneity in cells linked to the metastatic spread of the disease.
“The circulation of malignant cells in the blood is a critical component of the metastatic process,” Dr. Amato says. “Identification and characterization of CTCs may provide important insights into the biology of metastasis and serve as critical tools for treatment management.
Tumor-specific somatic mutations may serve as predictive biomarkers of tumor response and also may be valuable in choosing appropriate treatments, benefiting cancer patients by maximizing therapeutic effectiveness and minimizing adverse drug reactions — the hallmark of personalized gene targeted cancer therapy.”
Joseph Lucci III, M.D., professor in the department of Obstetrics, Gynecology and Reproductive Sciences at McGovern Medical School, is site principal investigator of a trial of a new drug for women with relapsed ovarian cancer. To be eligible for the trial, patients must have responded to previous platinum-based chemotherapy and have a harmful mutation in either the BRCA1 or BRCA2 gene.
The drug is olaparib, which stops an enzyme called PARP (poly [adenosine diphosphate-ribose] polymerase) from working. “In normal cells when a strand of DNA is damaged, PARP helps to repair it,” Dr. Lucci says. “The BRCA1 and BRCA2 genes produce tumor-suppressing proteins, providing another way to repair damaged DNA. Cancer cells that do not have these proteins due to mutation in the genes are unable to repair themselves.
When both ways of repairing damaged DNA are not working, cancer cells die, which makes olaparib of clinical interest for the treatment of women with advanced BRCA-mutated ovarian cancer.”
As a teaching hospital affiliated with a medical school, Memorial Hermann-TMC offers patients access to innovative treatments and technologies early in their development and testing phases, and soon after becoming approved by the Food & Drug Administration. Patients who qualify also have the opportunity to participate in clinical trials of treatments that would not otherwise be available to them.
“Much of the clinical research we do helps to determine whether an experimental drug is safe and effective, and ultimately contributes to the FDA’s determination of whether drugs and devices will be approved for marketing and use as standard-of-care treatments,” Dr. Amato says. “Clinical and research data is also being utilized increasingly to inform and improve physician practice patterns and hospital clinical operations and to answer further clinical queries and research questions. Any one of the clinical trials under way at Memorial Hermann and UTHealth could have a long-term impact on how patient care is delivered locally or nationally.”
Memorial Hermann Expands Lung Cancer Screening Program Focused on Early Detection
Lung cancer, both small cell and non-small cell, is the second most common cancer in both men and women, after prostate cancer in men and breast cancer in women. Only skin cancer is more common, according to the American Cancer Society. For patients at high risk of developing lung cancer, Memorial Hermann expanded its Low-Dose Computed Tomography (LDCT) screening program to multiple locations throughout the Greater Houston area, with a goal of improving patient outcomes by identifying lung cancer in its early stages.
From 2015 to 2016, Memorial Hermann saw a 97 percent increase in the number of lung screenings performed throughout the system.
In conjunction with the screening program, Memorial Hermann launched a South Region Lung Program for cancer patients, with a multidisciplinary lung tumor board and a dedicated Oncology Nurse Navigator serving Memorial Hermann Southwest Hospital, Memorial Hermann Southeast Hospital, and Memorial Hermann Sugar Land Hospital.
“From screening through diagnosis, treatment and survivorship, we work with patients individually to help them overcome barriers to healthcare access and ensure as positive an experience as possible,” says Deidra Teoh, RN, OCN, who has been an Oncology Nurse Navigator since 2011 and rejoined Memorial Hermann in July 2016. “We’re pleased to offer patients an innovative way to get answers to their questions about their personal care based on opinions from a large multidisciplinary team of physicians.”
Pulmonologists, thoracic surgeons, medical oncologists, radiation oncologists and pathologists who specialize in lung malignancies come together to review cases and recommend treatment plans.
In 2017, the System expanded the tumor board even further and invites physician participation from across the Greater Houston area. Physicians interested in participating in the tumor board should contact Maria Tran, System Director of Memorial Hermann’s Cancer Registry, at 713.338.5971 or maria.tran@ memorialhermann.org.
More information on the Lung Cancer Screening Program at Memorial Hermann, including a list of screening locations, may be found at cancer.memorialhermann.org/lung-cancer.
Community Outreach, Prevention and Education
Yoga at Canopy – A Cancer Survivorship Center at Memorial Hermann The Woodlands Hospital.
As an accredited Commission on Cancer Integrated Network Cancer Program, Memorial Hermann is proud of the outreach it does in both the Greater Houston community and for the patients that entrust us with their care. Following evidence-based guidelines, Memorial Hermann Cancer Centers develop and conduct dozens of support programs each year focused on prevention, education, screening and community outreach.
In 2016, Memorial Hermann opened two cancer survivorship centers – Canopy at Memorial Hermann The Woodlands Hospital and the Lindig Family Cancer Resource Center at Memorial Hermann Memorial City Medical Center. While these centers are just two of the eight sites throughout Greater Houston that offer cancer survivorship support, their openings have provided even greater access to programs for hundreds of patients and their caregivers, regardless if their treatment was received at Memorial Hermann. Since opening last summer, more than 1,600 patients have participated in more than 50 programs at Canopy, and 680 patients have participated in the 19 programs offered at the Lindig Family Cancer Resource Center. In addition to traditional support groups, programs offered at these campuses include: Chair Yoga, Creative Healing Through Art, Knitting, Eating Well Through Cancer, Lymphedema Support, Meditation, and many more.
The work Memorial Hermann does extends outside of the hospital setting, as our Cancer Centers also partner with community organizations like the American Cancer Society, Pink Door, CanCare and Ovarcome to support their efforts in the fight against cancer. By working together, these nonprofit organizations are able to benefit from the expertise of our oncology nurses and affiliated physicians, and Memorial Hermann is able to offer patients even more options to choose from in terms of survivorship support.
Mandi Roach, along with more than 1,600 other cancer survivors, utilized Canopy’s programs in 2016.
Memorial Hermann Cancer Centers held five free community screenings for breast, skin, prostate, colon, and head and neck cancers in 2016. These events welcomed more than 250 people and provided potentially lifesaving screenings they may have otherwise not have had access to.
Memorial Hermann is continually evaluating new and innovative ways to spread awareness and educational information to the community. Through the continued optimization of the system’s digital assets – including the Memorial Hermann Cancer Centers website and System social media channels – we have been able to extend our voice even further.
As part of these ongoing efforts, our Centers began conducting Facebook Live presentations featuring an affiliated oncology physician and nurse navigator, to provide information on the prevention and early detection of cancer. Topics in 2016 included educating the community on the differences between 2D and 3D mammography, as well as Low-Dose Computed Tomography (LDCT) screenings for lung cancer.
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