UNC REX Cancer Center Annual Report 2019

UNC REX CANCER CARE

ANNUAL REPORT 2019

A COMPREHENSIVE COMMUNITY CANCER PROGRAM

Accredited by the American College of Surgeons Commission on Cancer
National Accreditation Program for Breast Centers
Cary East Raleigh Garner Raleigh Main Raleigh Blue Ridge Wakefield

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On the cover: UNC REX Cancer Care - Blue Ridge

2605 Blue Ridge Rd, Raleigh, NC 27607

UNC REX Cancer Care locations
Cary ~ East Raleigh ~ Garner ~ Raleigh Main ~ Raleigh Blue Ridge ~Wakefield

For more information or to schedule an appointment with UNC REX Cancer Care
Call 919-784-3105

https://www.rexhealth.com/rh/care-treatment/cancer/

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UNC REX Cancer Care

Mission, Vision, Values

At UNC REX Healthcare, we value our patients, co-workers and community. Our Mission, Vision and Values
reflect every aspect of who we are and how we care for our community and each other.
For more than 120 years, UNC REX has met the health care needs of our community by providing services
throughout Wake County and beyond.
As a leader in the health care industry, we are consistently raising the bar throughout UNC REX Healthcare. We
look forward to extending our mission of providing the best in health services through compassionate care and
leading-edge technology, both inside and beyond the walls of the hospital, to build and sustain a healthy commu-
nity.

Mission

Inspiring hope, improving health and healing communities

Vision

Leading the transformation of health care, one person at a time

Values

 Patients and Families First

 Ensuring excellence in patient safety, quality and accountability. Achieving top performance in every outcome
for our patients

 Champion Teamwork

 Collaborating with patients, physicians, co-workers and the UNC Health Care system to being health and well-
ness to our community. Honoring respect, diversity and trust. Caring and compassion for each other and our
patients

 Build Communities

 Treating our patients, visitors and co-workers like family. Creating a stronger community through passion,
dedication and a commitment to caring for all. Reaching underserved populations

 Drive Change

 Developing new ideas and ways of doing our work. Growing knowledge, expertise and learning

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UNC REX Cancer Care Annual Report 2019

Table of Contents Page

 Mission & Core Values 3
 Letter from Our Cancer Committee Chair 5
 Introduction 6
 Accreditations and Eligibility Requirements 7
 Cancer Registry Site Distribution 8
 Quality and Accountability Measures 9
 Cancer Quality Care Initiatives 10
 Cancer Research and Clinical Trials 11
 Excellence in Publications and Presentations 12
 Community Cancer Care 15
 Cancer Care Services and Locations 16

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A Letter from Our Chair -

UNC REX Cancer Care Committee

Keith E. Volmar, MD
UNC REX Pathology Associates - UNC REX Healthcare

Dear Friends,

It is an honor to take on the role of UNC Rex Cancer Care Committee Chair. I am grateful for the hard work of
my predecessors and our future efforts that follow. The Annual Report highlights the important work that goes on
behind the scenes in cancer care and service leadership. These efforts demonstrate the diligence of our
multidisciplinary members and collaborative guidance of the tumor registry, quality and administration working
together.
UNC Rex Cancer Care continues to grow to meet expanding community needs, with over 3,000 new cancer patients
diagnosed annually. In response, the new UNC REX Cancer Center broke ground this year, with the design
benefitting from a wide variety of stakeholders. Preliminary work is in progress on the infrastructure and building
completion is expected in late 2021.
Combining physicians and staff from Main Campus and Blue Ridge will provide a hub that encourages the
compassionate care patients and families expect in a building designed to enhance the use of space and technology,
collaborative multi-disciplinary care and leading edge treatments.
All this is possible because of the excellent work and service coordination of UNC REX Cancer Care co-workers,
our physicians, practitioners, nurses, navigators, and more, who serve our patients, their families and their
caregivers.
I want to offer special thanks for the support of UNC REX Cancer Care’s leadership. They are always guiding,
inquiring, assessing, and advocating forces in this journey:

Kathy Foote, CTR, Tumor Registry Manager, Cynthia Jones, CPHQ, Quality Leader, and
Tom Grates, Associate Vice President of UNC REX Cancer Center.

Sincerely,
K. Volmar, MD

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Introduction

The UNC REX Cancer Care Committee is the designated multidisciplinary body for program leadership,
administrative oversight, development, and review of oncology services at UNC REX Cancer Care. The Cancer Care
Committee is a committee of the UNC REX Hospital Medical Staff responsible for the overall direction of the
oncology program including coordination with Hospital and UNC Health System leadership. Its composition, as
required by the Commission on Cancer, includes Board-certified physicians from Surgery, Medical Oncology,
Radiation Oncology, Diagnostic Radiology, and Pathology, along with the Cancer Liaison Physician, Clinical
Research Manager, Palliative Care Specialist, and representatives from Hospital Administration, Nursing, Pharmacy,
Genetics, Psychosocial services, Cancer Registry, and Quality.

Annually, as required by the Commission on Cancer, the UNC REX Cancer Care Committee develops a report with
dedicated focus on program quality and outcomes. These findings are published through the UNC REX Cancer
Annual Report and available to public.

Cancer Care Committee Membership 2019

Appointed Membership Appointed Member Alte rnate
Dr. Keith Volmar Dr. Rachel Jendro
Committee Chair Dr. Duncan Chapman Dr. David Schulz
Diagnostic Radiology Dr. Richard Gillespie (CLP) Dr. Albert Chang
Surgeon Dr. Keith Volmar Dr. Keith Nance
Pathologist Dr. Charles Eisenbeis Dr. Brendan McNulty
Medical Oncologist Dr. Courtney Bui Dr. Nathan Sheets
Radiation Oncologist Tom Grates, MBA, AVP Stacy Szeglowski, MBA
Program Administrator Dr. Hiren Mehta Dr. Rachel Jendro
Cancer Conference Coordinator Kimberly Hurley, RN Sharon Kauffman, RN, MSN
Oncology Nurse Arqueta Lindsey, MSW Melinda Lopez, MSW, LCSW
Social Worker/Psychosocial Kathy Foote, MBA, CTR
Certified Tumor Registrar Cynthia Jones, BS, CPHQ Heather Sasser, RN
Quality Improvement Catherine Fine, MS, CGC Ofri Leitner, MS, CGC
Genetics Counselor Rachel Smith, M. Div, THM Jennifer Burdette, MSW
Palliative Care Nancy Burns, RN Kaitlyn Moore, BS
Clinical Trials/Research Emmeline Madsen, MPH Chrissy Moore, BS
Community Relations/Outreach

Supporting Membershp Appointed Member
Breast Program Leadership
Specialty Physicians Dr. Rachel Jendro (BPL Chair)

Patient Navigation Dr. Nihan Cannon (Hospitalist) Dr. Susan Moore (Director)
Nutrition Services
Pharmacist Dr. Douglas Hammer (PCP)
Rehabilitation
American Cancer Society Susan Mondo, RN, MSN

Suzanne Smith, RD, CSO, LDN

Jonathan Gerber, PharmD Becky Jones, PharmD

Nancy Reifsteck, OTR

Robbie Tilley

Coordinators Appointed Member
Cancer Conference Dr. Hiren Mehta
Quality Improvement Cynthia Jones, CPHQ
Cancer Registry Quality Kathy Foote, CTR
Community Outreach Emmeline Madsen, MPH
Clinical Research Nancy Burns, RN
Psychosocial Services Arqueta Lindsey, MSW

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UNC REX Cancer Care Accreditations

UNC REX Cancer Care is voluntarily accredited by the American College of Surgeons Commission (ACoS) per
the Commission on Cancer (CoC) Standards as a Comprehensive Community Cancer Program (CCCP). The pro-
gram assesses more than 3,000 newly diagnosed cancer cases each year, provides a full range of diagnostic and
comprehensive treatment services as noted below, either on-site or by referral, as well as participates in cancer-
related clinical research and cancer-related clinical trials, per CoC Standards.

UNC REX Cancer Care is also voluntarily accredited by the National Accreditation Program for Breast Centers
(NAPBC). The NAPBC holds organizations to the highest standards of care for patients with diseases of the breast.
UNC REX is accredited by the Joint Commission and ACR Breast Imaging Center of Excellence.

UNC REX Cancer Care meets and /or exceeds the Commission on Cancer 12 Eligibility Requirements:

Eligibility Requirements Specifications

Cancer Committee Responsibilities Annual monitoring, assessing, and identifying changes that are needed in each of
the eligibility requirements.

Facility Accreditation The facility is accredited by a recognized federal, state, or local authority.
Cancer Committee Authority
Bylaws or policy and procedure define the cancer committee’s authority and re-
sponsibility for the program.

Cancer Conference Policy Program policy addresses the frequency, format, multidisciplinary attendance, at-
tendance rate, prospective case presentations and total case presentations, discus-
sion of stage and treatment planning, clinical trial options, and methods to ad-
dress opportunities.

Oncology Nurse Leadership An oncology nurse provides leadership within the program.

Cancer Registry Policy & Procedure Policy and procedure addresses the use of Commission on Cancer data & all
Diagnostic Imaging other cancer registry activities.

Services are provided. *

Radiation Oncology Services Radiation treatment service locations are currently accredited by a recognized
Systemic Services authority or, if not accredited, follow standard quality assurance practices. *

Policies or procedures are in place to guide the safe administration of systemic
therapy.*

Clinical Trial Information A policy or procedure is used to inform patients about clinical trials.
Psychosocial Services
A policy or procedure is in place to ensure patient access to psychosocial ser-
vices.*

Rehabilitation Services Rehabilitative services are provided. *
Nutrition Services Nutrition services are provided.*

Source: CoC, 2016 * Services are available either on-site, at locations that are facility owned, or by referral.

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UNC REX Cancer Registry Site Distribution CY 2018

PRIMARY SITE TOTAL CLASS SEX AJCC STAGE

A N/A M F 0 I II III IV Unk N/A

ALL SITES 3598 3290 308 1422 2176 287 1056 482 427 546 470 330

BREAST 1083 1002 81 7 1076 174 554 132 52 33 120 18

DIGESTIVE 525 480 45 281 244 10 72 61 141 147 82 12

Colon 154 141 13 84 70 1 29 30 51 31 12 0
Rectum 103 95 8 66 37
Pancreas 91 89 2 43 48 0 17 5 45 13 23 0
Stomach 45 43 2 24 21
Anus/Anal Canal 32 20 12 9 23 0 11 9 9 50 10 2
Liver 28 24 4 18 10
Esop hagus 21 20 1 17 4 0 8 5 7 16 9 0
Other 51 48 3 20 31
8 0 5 9190
RESPIRATORY 395 371 24 203 192
0 3 1 5 12 6 1
Lung/Bronc-NSC 294 275 19 145 149
Lung/Bronc-SC 63 60 3 33 30 0 0 0 6 11 2 2
Other Lung/Bronc 17 16 1 89
Lary nx 12 11 1 10 2 1 4 6 9 13 11 7
Nasal/Sinus 1 1 0 01
Other 8 8 0 71 2 101 29 74 150 39 0

MALE GENITAL 379 308 71 379 0 1 80 25 59 102 27 0

Prostate 362 292 70 362 0 0 9 4 11 35 4 0
Testis 15 14 1 15 0
0 7 0 0910
BLOOD & BM 220 209 11 126 94
1 3 0 3410
Leukemia 94 92 2 60 34 0 1 0 0000
M ultiple M yeloma 52 47 5 23 29 0 1 0 1060
Other 74 70 4 43 31
0 35 184 75 35 49 1
GYNECOLOGIC 197 170 27 0 197
0 35 182 74 35 36 0
Corpus Uteri 115 109 6 0 115
Ovary 37 34 3 0 37 0 0 2 1 0 12 0
Vulva 19 5 14 0 19
Cervix Uteri 13 10 3 0 13 0 0 0 2 45 5 168
Other 13 12 1 0 13
0 0 0 2 45 3 44
URINARY 202 188 14 141 61
0 0 0 0 0 1 51
Bladder 123 118 5 95 28
Kidney /Renal 70 61 9 40 30 0 0 0 0 0 1 73
Other 9 9 0 63
2 76 13 28 16 45 17
SKIN 146 135 11 77 69
0 64 7 14 9 21 0
M elanoma 134 124 10 71 63
Other 12 11 1 66 0 9 2 9 4 13 0

LYMPHATIC 143 135 8 78 65 2 1 0 0 0 4 12

Non-Hodgkin's 124 116 8 71 53 0 2 3 0341
Hodgkin's 19 19 0 7 12
0 0 1 5034
ENDOCRINE 130 128 2 29 101
67 37 11 10 19 53 5
T hy roid 119 119 0 25 94
Other 11 9 2 47 63 27 9 7 4 11 2

BRAIN & CNS 76 69 7 32 44 2 9 2 2 14 41 0

Brain (M alignant) 26 26 0 15 11 2 1 0 1113
Other 49 43 6 17 32
32 55 12 7 3 33 4
ORAL 53 49 4 45 8
31 54 9 5 3 31 1
Tongue 22 21 1 19 3
Hy p op hary nx 5 5 0 50 1 1 3 2023
Orop hary nx 4 4 0 31
Other 22 19 3 18 4 0 17 17 27 71 4 7
CONT TISSUE 14 12 2 95
0 14 11 24 64 4 7
BONE 3 3 0
0 3 6 3700

0 97 12 1 3 7 10

0 97 12 1 2 7 0
0 0 0 0 1 0 10

0 0 0 0 0 14 62

Classification by WHO 10 16
4 45

0 8 6 9 19 10 1

0 5 3 1760

0 0 0 0401

0 1 0 2100

0 2 3 6740

0 4 20125

2 1 0 0 00111

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Rapid Quality Reporting System

UNC REX is proud to utilize the Rapid Quality Reporting System (RQRS) as an early adaptor prior to the 2017 CoC
requirement. RQRS helps programs deliver evidence-based cancer care and facilitate quality improvement with
concurrent patient data. Through RQRS’ web-based tool, programs receive notifications of treatment expectations and
timeliness of care.

In addition, RQRS real time data alerts notify the service of year-to-date concordance rates for each measure, case details,
and comparison to state, other hospital groups, and hospitals at the national level.

Through active utilization of RQRS, UNC REX is in excellent standing for the current measures.

Importantly to note is the significance of the designated Accountability Measures as endorsed by the Na-
tional Quality Forum (NQF). Our performance against Expected Performance Rates (EPR) are:

Measure UNC REX* ACoS CoC Expected Performance Rate

 BCSRT (Breast) 88 % EPR 90% * This is a snapshot:
 HT (Breast): 87 % EPR 90% Rates move and increase as
 MAC (Breast): 90 % None at this time patients continue to complete
 MASTRT (Breast) 86 % EPR 90%
 12RLN (Colon) 100 % None at this time appropriate and timely
 ACT (Colon) 100% None at this time treatments

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UNC REX Cancer Care Quality Initiatives 2019

Each year, the UNC REX Cancer Care Committee identifies and evaluates opportunities and problematic areas,
as an organization built upon a just culture, lean methodologies and quality improvement guiding principles.
These efforts engage multidisciplinary members and co-workers from clinical, administration and patient
perspectives. When applicable, these are compared against evidence based standards, emerging therapies,
benchmarks, goals and best practices.

An overview for 2019 includes:

 Quality Study: Beta-Blocker Therapy for the Prevention of Doxorubicin-Induced Cardiotoxicity

o A Retrospective Cohort Study: (n=114) O. Witt, PharmD, D. Blanchard, RPh, R. Jones, PharmD,
BCPS, O. Kamneva, PharmD, BCPS-AQ, S.Baumhover, PharmD, BCPS:

o Outcomes: Patients treated with conventional doxorubicin therapy and concomitant select beta-
blockers did not experience additional protection against development of cardiotoxicity.

 Quality Study: Avoidable Denials - Rex Hematology Oncology Associates

o A Lean Express Workout A3: Heather Sasser, BSN, RN, (Kaizen Coach), Jennifer Headen, MBA
(HemOnc), Mistry Peacock, (Revenue Cycle) Lisa Muratovic, MBA (Radiation)

o Outcome: Problem- identified 31 process gaps that created waste, delays, and financial burden
o Actions: reduced avoidable denials by $22K /month ($270K annualized)

 Quality Study: Increases in Identificaiotn of of Radial Scars- What is our Population Risk today?

o A Retrospective Study: (n=65/2,683 VABB) (6 years) Rachel Jendro, DO, (Surgeon) Kelli-Poe-
Jones, RT, (Imaging) Cynthia Jones, BS, CPHQ (Quality)

o Outcomes: Improvements in 3D mammography have significantly increased identification of RS.
Although RS are benign, but also associated with underlying risks (tumors,ADH). Does increased
RS correlate with an increase in cancer? Findings: No: Cancer risk remains low at 9%, ADH at 8%

 Clinical Goal: Provide Oncology and Hematology Patients with an Advance Care Plan

o Cancer Program Clinical Goal (Coc Stndard 1.5) Hospital MIPS Dashboard
o Heather Sasser, BSN, RN (Quality Coach), Tom Grates, AVP, Onc Advanced Practitioner Team
o Medicare Measure Quality ID #47 expects patients 65yrs > documented a code status, discussion

with provider or scanned legal documents stating their healthcare wishes.
o Advance Care Planning will improve alignment of care; decrease caregiver stress, anxiety, and

depression; and avoid unnecessary, burdensome and unwanted treatment.
o Accomplished: Program met and exceeded system goal of 67% at year end

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UNC REX Cancer Research and Clinical Trials

With the collective help of our doctors and cancer patients who choose to participate, clinical trials enable testing
of the latest research findings from the National Cancer Institute (NCI) and other research organizations. These
trials can take several years to complete, but the knowledge gained has led to an increase in the number of people
who survive cancer.

UNC REX Cancer Care participates in ongoing cancer clinical trials, including many in collaboration with UNC’s
Lineberger Comprehensive Cancer Center.

Available clinical trials include bio-banking and diagnostic studies, therapeutic trials, quality-of-life and support-
ive care trials.

Clinical Research Accrual ~ 2019

Type of Research Study Clinical research advances science and ensures
that patient care approaches the highest level of
Clinical Trials (104) quality

Diagnostic Trials UNC REX is proud to demonstrate Excellent
Performance at Commendation Level for Patient
Genetic Studies (1) Accrual

Prevention & Control Research Studies For reference: CoC minimum required accrual
rate is 4% for Comprehensive Community
Cancer Programs (CCCP) (CoC Standard 1.9)

Bio-Repository & Bio-Bank Studies

Patient Registry Studies (489)

Other Not Specified (NOPR) (1)

Total Enrolled (595)

Percent Enrolled 18.0%

To learn about clinical trials offered by UNC REX Cancer Care, or your eligibility
Call 919-784-7209 http://www.rexhealth.com/rh/care-treatment/clinical-trials/cancer/

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UNC REX Cancer Excellence in Publications and Presentations

UNC REX Cancer Care physicians and clinical staff support the advancement of oncology care
through professional publications and presentations

Books & Publications:

Assessment of Risk of Xerostomia after Whole-Brain Radiation Therapy and Association with Parotid Dose.
Wang K, Pearlstein KA, Moon DH, Mahbooba ZM, Deal AM, Wang Y, Sutton SR, Motley BB, Judy
GD, Holmes JA, Sheets NC, Kasibhatla MS, Pacholke HD, Shen CJ, Zagar TM, Marks LB, Chera BS.
JAMA Oncol. 2019 Feb 1;5(2):221-228.

Clinical history and clinical correlation. Volmar KE.. In: Nakhleh RE, Volmar KE, editors. Error Reduction and
Prevention in Surgical Pathology. 2nd ed. New York: Springer; 2019.

De novo compartment deconvolution and weight estimation of tumor tissue samples (DECODER). Peng XL,
Moffitt RA, Torphy RJ, Volmar KE, Yeh JJ. Nat Commun. 2019 Oct 18;10(1).

Dual HER2-Targeting in the Adjuvant Setting: Where We Have Been and Where We Are Going.. Copeland
AC, Anders CK. Oncology (Williston Park). 2018;32(10):483–487.

Error Reduction and Prevention in Surgical Pathology 2nd ed. Nakhleh RE, Volmar KE, editors.. New York:
Springer; 2019.

Error Reduction and Prevention in Surgical Pathology. 2nd ed. Volmar KE. Tracking of report defects. In: Na-
khleh RE, Volmar KE, editors. New York: Springer; 2019

Evaluating the adoption of laboratory practice guidelines. Goldsmith JD, Fitzgibbons PL, Fatheree LA, Astles
JR, Nowak JA, Souers RJ, Volmar KE, Nakhleh RE.. Arch Pathol Lab Med. 2019 Jun 18.

Malignant Brenner tumor of the ovary: Case series and review of treatment strategies. Gynecologic Oncology
Reports. Zhang Y, Staley SA, Tucker K, Clark Leslie H..2019 Feb; 28: 29-32.

“Perioperative Management of Complications” in Lobo et al. Comprehensive Gynecology, 8th Edition. Clark,
Leslie H., Gehrig PA. In press, 2019.

Phase II Trial of De-Intensified Chemoradiotherapy for Human Papillomavirus-Associated Oropharyngeal
Squamous Cell Carcinoma. Chera BS, Amdur RJ, Green R, Shen C, Gupta G, Tan X, Knowles M,
Fried D, Hayes N, Weiss J, Grilley-Olson J, Patel S, Zanation A, Hackman T, Zevallos J, Blumberg J,
Patel S, Kasibhatla M, Sheets N, Weissler M, Yarbrough W, Mendenhall W.
J Clin Oncol. 2019 Oct 10;37(29):2661-2669.

Prolonged remission of cancer of unknown primary following initiation of eculizumab therapy for paroxysmal
nocturnal hemoglobinuria. Lim MY, Volmar KE, Key NS. Case Reps Hematol..July 2, 2019

Prospective Assessment of Patient-Reported Dry Eye Syndrome after Whole Brain Radiation.
Wang K, Tobillo R, Mavroidis P, Pappafotis R, Pearlstein KA, Moon DH, Mahbooba ZM, Deal AM,
Holmes JA, Sheets NC, Kasibhatla MS, Pacholke HD, Royce TJ, Weiner AA, Shen CJ, Zagar TM,
Marks LB, Chera BS. Int J Radiat Oncol Biol Phys. 2019 Nov 15;105(4):765-772.

Quality of Life for Patients with Favorable-Risk HPV-Associated Oropharyngeal Cancer after De-intensified
Chemoradiotherapy. Pearlstein KA, Wang K, Amdur RJ, Shen CJ, Dagan R, Weiss J, Grilley-Olson JE,
Zanation A, Hackman TG, Thorp BD, Blumberg JM, Patel S, Sheets N, Weissler MC, Mendenhall WM,
Chera BS. Int J Radiat Oncol Biol Phys. 2019 Mar 1;103(3):646-653.

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Relationships of p16 immunohistochemistry and other biomarkers with diagnoses of cervical abnormalities: im-
plications for LAST terminology Castle PE, p16 Study Panel, et al.. Volmar KE Arch Pathol Lab Med.
Nov 13 2019.

Shoulder symptoms and quality of life impact of limited neck dissection after de-intensified chemoradiotherapy:
Secondary analysis of two prospective trials. Wang K, Moon DH, Amdur RJ, Dagan R, Sheets NC,
Shen CJ, Green R, Patel SN, Zanation AM, Thorp BD, Hackman TG, Weissler MC, Mendenhall WM,
Chera BS. Head Neck. 2019 May;41(5):1213-1219.

“Surgery for Pre-invasive disease of the cervix” in TeLinde’s Operative Gynecology. 12th edition. Clark, Leslie
H., Wolters Kluwer, 2020. Pages 406-413.

The utility of a telemedicine platform to monitor adherence and adverse effects of tyrosine kinase inhibitors
Anureet C. Copeland, Matthew C. Foster, Benyam Muluneh, James G. Xenakis, Anastasia Ivanova,
Olga Frankfurt, Monique Clayton, Anderson Black, Barbara Rapchak & Robert S. Wehbie (2019) , Leu-
kemia & Lymphoma, 60:7, 1842- 1844

Work habits contributing to error in surgical pathology. Volmar KE. In: Nakhleh RE, Volmar KE, editors. Error
Reduction and Prevention in Surgical Pathology. 2nd ed. New York: Springer; 2019.

Posters & Presentations:

A comparison of postoperative morbidity in open versus robotic-assisted interval debulking surgery for epithe-
lial ovarian cancer (EOC) patients following neoadjuvant chemotherapy. Zhang, Y., Staley, A., Tucker,
K., Paraghamian, S. E., Wang, M., & Clark, LH. Poster Presentation Society of Gynecology Oncology,
50th Annual Meeting on Women’s Cancer. March 16-19, 2019. Honolulu,

Assessment of the false negative rate of preoperative imaging in cervical cancer patients undergoing primary
radical surgery Staley SA, Tucker K, Paraghamian S, Wang M, Gehrig PA, Clark LH.. Poster Presenta-
tion Society of Gynecology Oncology, 50th Annual Meeting on Women’s Cancer. March 16-19, 2019.
Honolulu, HI.

Assessment of the false negative rate of preoperative imaging in cervical cancer patients undergoing primary
radical surgery. Staley SA, Tucker KR, Gehrig P, Clark LH. Society of Gynecologic Oncology Winter
Meeting, Lake Tahoe, CA, January 17-19 2019.

Can preoperative cervical excision pathology predict the need for adjuvant radiation in early-stage cervix can-
cer? Tucker K, Staley SA, Wang M, Rossi E, Gehrig PA, Clark LH. Poster Presentation Society of Gy-
necology Oncology, 50th Annual Meeting on Women’s Cancer. March 16-19, 2019. Honolulu.

Contemporary incidence of medical inoperability in endometrial cancer. Ertel M, Staley A, Clark LH. Poster
presentation at 34th Annual Meeting of MAGOS. Charlotte, NC. October 2019.

How often do patients with early-stage cervix cancer require dual modality treatment due to inaccurate staging
on clinical exam and preoperative imaging? Tucker K, Staley SA, Wang M, Rossi E, Gehrig PA, Clark
LH. Poster Presentation Society of Gynecology Oncology, 50th Annual Meeting on Women’s Can-
cer. March 16-19, 2019. Honolulu, HI.

Postoperative survival analysis of laparotomy versus robotic interval debulking in epithelial ovarian cancer pa-
tients following neoadjuvant chemotherapy. Paraghamian S, Staley SA, Tucker K, Wang M, Clark LH.
Poster Presentation Society of Gynecology Oncology, 50th Annual Meeting on Women’s Cancer. March
16-19, 2019. Honolulu, HI.

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Surgical pathology and diagnostic error prevention. United States and Canadian Academy of Pathology Annual
Meeting. CME course. Nakhleh RE and Volmar KE. Washington, DC, March 2019.

Survival impact of neoadjuvant and adjuvant chemotherapy cycles stratified by interval debulking surgical ap-
proach in advanced epithelial ovarian cancer. Zhang Y, Paraghamian S, Clark LH. Oral presentation at
34th Annual Meeting of MAGOS. Charlotte, NC. October 2019.

Reducing Chemotherapy Release Time on an Inpatient Oncology Unit. Thigpen, A., Williams, K., Jones, R.,
Moody, M., Pham, P.

 North Carolina Organization for Nurse Leaders, Greensboro, NC. March 2019
 UNC Innovation at the Point of Care: Nursing Quality and Research Conference. April 2019
 Triangle Oncology Nursing Society Posters on Parade, Durham, NC. June 2019
 ANCC, Pathway to Excellence Conference, West Palm Beach, FL. May 2020
 National Association of Clinical Nurse Specialists, Indianapolis, IN. March 2020

Education & Digital Media

Cooking Cancer Free Class. Gwyn Hardin RD, CSO, LDN, Stacy Shappley, RD, CSO, Suzanne Smith, RD,
CSO, LDN, North Carolina Heart & Vascular Hospital, Raleigh, NC. Oct 23, 2019.

Get in the Game: The Ins and Outs of Colorectal Cancer: Patient Care Navigation in Care Coordination.
Rhonda Dickerson, BSN, RN. UNC REX Bariatric Services Forum. March 2019.

How What You Eat Can Affect Your Risk of Cancer. UNC Health Talk. Stacy Shappley, RD, CSO,
https://healthtalk.unchealthcare.org/how-what-you-eat-can-affect-your-risk-of-cancer/ Aug 28, 2019.

Post-Cancer Rehab: Easing Back into Daily Life after Cancer. UNC Health Talk. Valerie Hunsel, OT/L, CLT,
https://healthtalk.unchealthcare.org/post-cancer-rehab-easing-back-into-daily-life-after-cancer/ Nov 6,
2019.

Swelling in Your Limbs? It Could Be Lymphedema. UNC Health Talk. Valerie Hunsel, OT/L, CLT, Connie
Nehls, MS, PT, CLT, https://healthtalk.unchealthcare.org/swelling-in-your-limbs-it-could-be-
lymphedema/ Sept 18, 2019.

Oncology Nursing Grand Rounds
Hemolytic Anemia: Jamie Banwell, MSN, RN. Apr 19, 2019
Lymphoma: Alison Casey, MSN, RN. Mar 15, 2019
Multiple Myeloma: Anne McKnight, MSN, RN, Kelly McLaughlin, MSN, RN. Apr 2019
Ovarian Cancer: Ellen Byars, MSN, RN. Aug 16, 2019.
Pancreatic Cancer: Clare W. Bremer, MSN, RN, Denise Pescaro, MSN, RN. Jan 8, 2019
Tobacco Cessation: Janet Dickmander, MSN, RN, Laurel Sisler, LCSW. May 17, 2019

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Comprehensive Community Cancer Care

UNC REX Cancer Care provides patients of Wake County and surrounding communities with exceptional cancer
care, including access to innovative treatments and support services. As the first nationally accredited Comprehensive
Community Cancer Center in North Carolina, we provide expert care, close to home, in several convenient locations.
In collaboration with UNC Lineberger Comprehensive Cancer Center, our physicians also access the latest in clinical
trials. Our physicians are at the helm of ongoing cancer research.

Multidisciplinary care is the heart of our program. Our board-certified physicians meet regularly and work together
as a team to develop a comprehensive treatment plan tailored to our patients’ needs.

UNC REX Cancer Care includes:
 REX Hematology Oncology Associates
o Raleigh – Main Campus, Raleigh - Blue Ridge, East Raleigh, Cary, Garner, Wakefield
 UNC REX Radiation Oncology
o Raleigh-Main Campus, East Raleigh, Clayton, Smithfield, Wakefield
 UNC REX Surgical Oncology – North Carolina Surgery
o REX Surgical Specialists
 Raleigh, Knightdale, Garner, Wakefield
o REX Thoracic Surgical Specialists
o REX Neurosurgery and Spine Specialists
 Raleigh, Cary
 UNC REX Pulmonary Specialists
o Raleigh, Holly Springs, Wakefield, Cary
 UNC REX Gynecologic Oncology
 UNC REX Comprehensive Breast Care Program
 UNC REX Cancer Genetics Program

We also provide patients and their families with access to oncology support services, including:

Patient Navigation Financial Counseling
Clinical Trials Educational Programs
Cancer Rehabilitation Support Groups
High Risk Nutritional Management Survivorship Support
Social Work and Psychosocial Support Wellness Services

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UNC REX Cancer Care Locations

REX HEMATOLOGY AND ONCOLOGY ASSOCIATES

RALEIGH – Main Campus Raleigh -BLUE RIDGE CARY
4420 Lake Boone Trail 2605 Blue Ridge Road Parkway Professional Park
Suite 200 Suite 190 150 Parkway Court, Suite 200
Raleigh, NC 27607 Raleigh, NC 27607 Cary, NC 27518
T: 919-784-6818 T: 919-784-6060 T: 984-974-2150
F: 919-784-6826 F: 919-784-6061 F: 984-974-2151

WAKEFIELD GARNER EAST RALEIGH
11200 Governor Manly Way 300 Health Park Drive 117 Sunnybrook Road
Suite 102 Suite 220 Raleigh, NC 27610
Raleigh, NC 27614 Garner, NC 27529 T: 919-334-3900
T: 919-570-7550 T: 919-250-5955 F: 919-250-9280
F: 919-570-7551 F: 919-250-5954

UNC REX RADIATION ONCOLOGY WAKEFIELD EAST RALEIGH
11200 Governor Manly Way 117 Sunny Brook Road
RALEIGH Suite 102 Raleigh, NC 27610
4420 Lake Boone Trail Raleigh, NC 27614 T: 919-334-3900
Suite 100 T: 919-570-7550 F: 919-250-9280
Raleigh, NC 27607 F: 919-570-7551
T: 919-784-3018
F: 919-784-1473

CLAYTON RADIATION ONCOLOGY SMITHFIELD RADIATION ONCOLOGY
Johnston Professional Plaza Johnston Medical Mall
2076 Highway 42 West Suite 1200
Suite 120 514 N. Bright Leaf Boulevard
Clayton, NC 27520 Smithfield, NC 27577
T: 919-585-8550 T: 919-209-3555
F: 919-585-5882 F: 919-938-7400

UNC REX BREAST CARE REX SURGICAL ASSOCIATES (Raleigh)
REX BREAST CARE CENTER (Breast Surgery)
(Diagnostic Imaging) 3100 Duraleigh Road, Suite 205
3100 Duraleigh Road, Suite 204 Raleigh, NC 27607
Raleigh, NC 27607 T: 919-784-7874
T: 919-784-6186

REX SURGICAL ASSOCIATES (Cary) REX SURGICAL ASSOCIATES (Wakefield)
300 Ashville Ave 11200 Governor Manly Way
Suite 240 REX Healthcare of Wakefield, Suite 208
Cary, NC 27518 Raleigh, NC 27614
T: 919-784-7874 T: 919-784-7874

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UNC REX Cancer Care Locations

REX NEUROSURGERY AND SPINE SPECIALISTS

T: 919-784-1410 F: 919-784-1409

RALEIGH CARY

4207 Lake Boone Trail, Suite 220 1505 SW Cary Parkway, Suite 302

Raleigh, NC 27607 Cary, NC 27511

REX SURGICAL SPECIALISTS -NORTH CAROLINA SURGERY

T: 919-784-7874 F: 919-784-2708

RALEIGH GARNER
300 Health Park Drive
Medical Office Building Suite 110
Garner, NC 27529
2800 Blue Ridge Road, Suite 300

Raleigh, NC 27607

KNIGHTDALE WAKEFIELD
6602 Knightdale Blvd, Suite 201 11200 Governor Manly Way, Suite 208
Knightdale, NC 27545 Raleigh, NC 27614

REX THORACIC SURGICAL SPECIALISTS

RALEIGH
4420 Lake Boone Trail
Suite 100
Raleigh, NC 27607
T: 919-784-5650

REX PULMONARY SPECIALISTS

RALEIGH T: 919-784-7460 WAKEFIELD T: 919-784-7460
4414 Lake Boone Trail 11081 Forest Pines Drive

Suite 402 Suite 104
Raleigh, NC 27607 Raleigh, NC 27614

HOLLY SPRINGS T: 919-567-6230 CARY T: 984-974-9200
781 Avent Ferry Road 300 Ashville Avenue
REX Healthcare-Holly Springs, Suite 200 Suite 301
Holly Springs, NC 27540 Cary, NC 27518

UNC REX GYNECOLOGIC ONCOLOGY

4420 Lake Boone Trail Parkway Professional Park
150 Parkway Court, Suite 200
Raleigh, NC 27607 Cary, NC 27518

T: 919-784-6875 F: 919-784-6890

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A- REX Cancer Care- Main Campus For more information or to schedule
B - REX Hematology Oncology Associates – Wakefield an appointment with
C - REX-UNC Radiation Oncology – Wakefield
D - REX Surgical Specialists – Wakefield UNC REX Cancer Care
E - REX Hematology Oncology Associates – Cary
F - REX Thoracic Surgical Specialists - Cary Call 919-784-3105
G - REX Neurosurgery & Spine Specialists – Cary
H - REX Hematology Oncology Associates – Garner www.REXhealth.com
I - REX Surgical Specialists – Garner
J - UNC Radiation Oncology at Clayton
K - UNC Radiation Oncology at Smithfield
L - UNC REX Cancer Care of East Raleigh

For more information or to schedule an appointment with UNC 18 | e

UNC REX Cancer Center
4420 Lake Boone Trail
Raleigh, NC 27607
919-784-3105
www.REXhealth.com

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