Wisconsin Cancer Center Offers State-of-the-Art Treatment, Home-Town Care

The following article appeared in the June, 2011 issue of Clinical Oncology News, an independent news source intended to serve the professional needs of oncologists and hematologist/oncologists. The mission of the publication is to provide readers with information that can be used to improve the quality of patient care and to reduce the cost. The publication exists to serve the needs of its readers and the patients for whom they care.

Wisconsin Cancer Center Offers State-of-the-Art Treatment, Home –Town Care
By Thomas McDonough

ProHealth Care Regional Cancer Center, headquartered at Waukesha Memorial Hospital in Waukesha, Wis., sums up its approach to fighting cancer in just five words — ”World class, close to home.” The center strives to provide patients with sophisticated diagnostic and cancer treatment technologies that are comparable to those of major academic research centers, yet with the up-close, personal care of a community hospital.

Clinical Research Equals Top-Level Care

“That’s our goal,” said Michael Thompson, MD, PhD, medical director of cancer research at the center. “Cancer patients can become highly stressed outside of their local support system and environment. We provide coordinated cancer care to people who want to stay in the community.”

By staying on the cutting edge of technology, employing a multidisciplinary approach to treatment and conducting high-quality research, ProHealth Care has earned a reputation for excellence. In 2007 and 2010, it received the American College of Surgeons Commission on Cancer Outstanding Achievement Award, and in 2009, the Wisconsin Cancer Council’s Community Service Award.

In addition to an outpatient clinic and dedicated inpatient unit at Waukesha Memorial Hospital, ProHealth Care operates two more outpatient clinics in Oconomowoc and Mukwonago, Wis. Its clinics treat most cancers — brain, breast, colorectal, lung, prostate and skin cancers, as well as leukemias and lymphomas. Within these clinic sites, specialty sites, such as the Center for Blood Cancer and Disorders, Gynecologic Oncology Service, Brain Tumor Treatment and Research Center and Center for Breast Cancer, allow clinicians to focus on particular tumor types.

ProHealth Care takes a multidisciplinary approach to treatment because all cancers are not the same. “There are important differences between any two cancers, even if they are from the same organ,” said medical director Peter Johnson, MD. “Each tumor type may require a special set of resources and support. We recognize that.” The center’s multidisciplinary team includes five hematology/oncology physicians, a neuro-oncologist, a hematologist, surgeons, pathologists, radiologists, care coordinators and nurses. The team reviews all cases at interdisciplinary conferences, developing comprehensive cancer care plans for patients.

“By having everybody in the same room at the same time we can look at films, have pathologists interpret biopsies and more,” said Dr. Johnson. “The benefit for the patient is that he or she can come in, see the people they need to see and get a plan everyone agrees on. They get more cohesive care.”

Another benefit for patients, according to Dr. Johnson, “is our great nurses. Anyone in a hospital knows you need really good nurses, and we have exceptional nurses, many who are oncology certified, and who have been here a long time. Patients are not objects here. They are treated like family members. It’s something that we’re good at.” This “keeps our patients coming back,” he added.

Making Cancer Care Manageable

Because a cancer diagnosis and resulting treatment can be a frightening and grueling experience for most people, ProHealth Care works hard to make the ordeal as manageable as possible, with the best outcomes and the least stress for patients.

A key to achieving that is its four patient navigators—one for patients with breast cancer, one for patients with prostate cancer and two for patients who are underinsured. “They are instrumental in guiding patients through treatment and helping them access resources, such as nursing assistance at home or hospice care if needed,” said Dr. Johnson.

ProHealth offers a cancer genetic risk assessment program for people whose cancer might have a hereditary component, and a cancer second opinion program, in which patients with breast, lung, prostate, brain or hematologic cancers can have ProHealth’s experts review their case and ensure they have been diagnosed correctly and have been provided with the best treatment options available, based on the most current evidence and research.

ProHealth works with the Stillwater Cancer Support Group, an affiliated, separate cancer support group that offers a variety of individual and familybased support, including access to complementary therapies, such as acupuncture and meditation.

The center also has a partnership with the Internet site, CaringBridge, which allows patients to create their own Web page while undergoing treatment. Through the Web page (www.caringbridge.org), patients can update family and friends on their progress and family and friends can post messages of support and encouragement.

“We found a lot of our patients were looking for a way to keep in touch with family and friends,” said patient support navigator Colette La Francis. “In CaringBridge, we found a very easy and accessible support system for them. These kinds of programs demonstrate how much we care for patients, and they set us apart from many other centers,” she added.

Technology for Better Outcomes

According to Wingate Clapper, MD, ProHealth Care’s medical director of radiation oncology, the center believes its investment in the most advanced, high-tech cancer diagnostic and treatment technologies provide patients with the best chance of beating their disease. “Radiation oncology is all about technology,” he said.

For example, the center is one of only 200 clinics worldwide using the CyberKnife System. CyberKnife delivers precise doses of radiation to tumors, while sparing surrounding healthy tissue. It can be used to treat a broad range of tumors, including prostate, lung, brain, spine, liver, pancreas and kidney tumors.” With CyberKnife, explained Dr. Clapper, “we localize a tumor on a six-dimensional grid, almost like a GPS grid. Then, we target the coordinates, and if there is any movement from the patient or the tumor, the machine moves with it.”

That’s critical in such cancers as lung cancer, where a patient’s breathing during treatment can cause tumor movement. “Because CyberKnife is more accurate and precise, we can deliver a greater dose of radiation, and we’re getting control and survival rates in earlystage lung cancer that are comparable to surgery,” Dr. Clapper said.

Besides CyberKnife, ProHealth makes use of robotic surgery technologies, such as the da Vinci Surgical System, and it is the first cancer clinic in Wisconsin to employ super-dimensional bronchoscopy to locate, test, diagnose and treat early-stage lung lesions.

“Our investment in technology puts us on par with academic research centers such as Stanford University, Cleveland Clinic and Georgetown University,” Dr. Clapper said. “We have a history of support from the administration to stay on the leading edge of technology, be it conventional radiation, such as linear accelerators, MRI [magnetic resonance imaging], and PET [positron emission tomography] scan technology, or cutting-edge technology, like CyberKnife. We take a very aggressive approach to go after it.”

Funding for such technology comes from ProHealth’s general budget, capital improvements and foundation-directed gifts, according to Dr. Thompson.

Clinical Research Equals Top-Level Care

For ProHealth Care, clinical research is a core value, and it is very active in enrolling patients in clinical and prevention trials. “Without clinical research, you’re not a player in the cancer game,” explained Dr. Thompson. “You must have it, if you want to deliver top-level care.” The center is involved in a number of studies involving breast, gastrointestinal, neurologic, thoracic, hematologic, gynecologic and genitourinary cancers.

“There are multiple reasons for excellent research programs,” said Dr. Thompson. “First is access to new drugs, which provides our patients with the most advanced, clinically approved treatments available. Second is to give our physicians a better understanding of the latest technology and treatments. And, it also helps us attract and retain good people.”

A typical study ProHealth has been involved in is the Eastern Cooperative Oncology Group’s E3A05 study, which collected bone marrow samples to help understand multiple myeloma and related diseases. “We accrued the most patients for that study,” Dr. Thompson said. “We’ve also collaborated on a Duke University study identifying types of microRNA and their relationship to lymphoma, and with a company called Tgen, where we looked at biomarkers for lung cancer.”

Recently, ProHealth Regional Cancer Center was among 14 hospitals nationwide to receive a $2.7 million grant from the National Cancer Institute to expand research programs, supportive care services and state-of-the-art cancer care to underserved populations. “The grant is designed to bridge the gap between cancer care at academic research centers and cancer care in the community,” said Timothy Wassenaar, MD, medical director for quality. “We are using the monies to hire and train bilingual patient navigators to reach our Hispanic population, sponsor screening events, conduct and better track more clinical trials and establish a palliative care program.”

Dr. Wassenaar pointed out that a big reason ProHealth attracts such funding is that it is a national leader in measuring outcomes. It tracks everything it does— surgical and treatment outcomes, treatment benchmarks, surgical standards, presurgery diagnostic evaluations, the levels of multidisciplinary care it provides, tumor incidences and more— through its cancer registry, which has a full-time staff. “We track data so diligently because we want to be sure we are providing quality care,” he said. “To have the ability to look at our outcomes, compared to those nationally, is tremendously helpful. It not only helps us care for patients, but also promotes a continuous learning process. We also seek transparency,” he added. “More and more patients and insurance companies require this kind of information.”

People Count

In the end, ProHealth Care Regional Cancer Center’s success comes down to treating the whole patient—his or her physical, psychological, emotional, nutritional, social and spiritual needs— and not just the tumor. “We have a core group of professionals who are passionate about and dedicated to taking care of cancer patients,” Dr. Johnson said. “One of our competitive advantages derives from our culture of compassion, and patients get a clear and consistent sense that we care about them.”

– Tom McDonough