Ganging Up On Cancer

Is there a word more frightening than cancer?

Cancer is the general name for a group of more than 100 diseases that start with abnormal cells growing out of control and invading other tissue. While cigarette smoking and sun exposure are two known causes of cancerous cells, there is still much that is not known about what causes cancer.

While research continues to try to understand the causes of cancer, there have been many advances in detecting and treating various forms of cancer.

Jerry Worrick with Cancer Center nurses (from left) Chris Giesseman RN, Jessica Kaye RN, Sharon Murrock RN, and Arlene Junion RN inside of Door County Memorial Hospital, Sturgeon Bay, Door County, WI. Photo by Len Villano.

In the not-too-distant past, Door County cancer patients had to travel for the latest in cancer treatments, but not any longer, thanks to a collaborative effort that includes a number of medical providers and the generosity of the community. Door County Cancer Center offers hope to county residents and stands as a testament to the vision and philanthropy of the community.

Read on to learn about some of those who are making a difference in fighting this insidious disease.

Imagine that it is the start of the 21st century. You are living in Ellison Bay and have just been diagnosed with cancer. One of the many components of your treatment is weeks of radiation therapy that you need every day, and the closest place for radiation treatment is Green Bay.

Now, among the many other things occupying your mind and body, you have to decide whether to make the 160-mile round-trip daily for the 15 or 20 minutes of radiation, or whether you will take a room in Green Bay through your treatment schedule.

“We’ve been doing chemotherapy here for probably more than 20 years,” said Jerry Worrick, CEO of Ministry Door County Medical Center. “The most irritating part of the cancer program for patients here was radiation. They would have to go down to Green Bay every day, Monday through Friday. That was real hardship.”

But due to what Worrick describes as “a generous community,” the Door County Cancer Center was built in 2005.

“About 11 years ago, St. Vincent [hospital of Green Bay] approached us and said they looked at some numbers and thought they could make radiation work here,” Worrick said.

“We worked with St. Vincent’s and put together the cancer center and they brought in the linear accelerator [for radiation treatments]. Of all the projects we’ve done up here, I’ve gotten more thanks or praise from the community for having that service here,” Worrick said. “The community’s always really responded to us in all our projects. We couldn’t have built a new addition or anything without the support of the community.” [See the sidebar for more on the $3 million campaign to build the Door County Cancer Center.]

In 2002 HSHS St. Vincent Hospital in Green Bay became one of only two hospitals in Wisconsin and 63 in the entire country to join the National Cancer Institute’s Community Clinical Oncology Program, creating the St. Vincent Cancer Research Institute and opening the door to clinical trials of promising new cancer treatments for its patients.

“We’ve brought Green Bay to Door County, basically, and partnered with all the strengths of regional services to provide the care in Door County,” said Sally Luehring, executive director, Cancer Services, HSHA Division, Eastern Wisconsin. “For decades, St. Vincent and Door County have collaborated on care for Door County patients for many things outside of cancer. Historically, we’ve had a very solid relationship.”

“Green Bay Oncology, our medical oncology partners, started providing outreach services to Door County Medical Center probably two decades ago, before the cancer center,” Luehring said. “They were providing medical oncology services a couple days a week in the hospital. About half the patients who are treated for cancer also need radiation oncology services. Unlike chemotherapy, which you might have once every two or three weeks, radiation therapy treatments are generally daily for several weeks. So traveling from Door County, especially the northern part of Door County every day was a huge burden and put a lot of extra challenges on patients already dealing with the effects of cancer and treatments. Anxiety and stress play a role in a patient’s ability to go effectively through their treatment. We understood that. We had already done some regional outreach with radiation in other parts of the state and really wanted to be able to offer that in Door County as well. Everybody had the same interest – Green Bay Oncology, Ministry Medical Center and St. Vincent – and wanted to complete the package and bring more complete, state-of-the-art cancer care to patients. In 2005 we found a way to make that work together. And that’s when the Door County Cancer Center was built.

“We were able then to move Green Bay Oncology medical oncology services directly into the center. And we brought the radiation oncology services there, all under one consolidated space, so the providers could work together, because medical oncologists and radiation oncologists work very closely together,” Luehring continued. “This takes the burden of travel off of the patients. Now they can open up their minds to some of the teaching and things they need to incorporate to do well. It provides a perfect location. The space designed there is a beautiful healing space. It feels good when you walk in there. It feels comforting and healing.”

“The medical oncology program that’s run by Green Bay Oncology, they are a great resource, especially the physicians who come up here. I tell people they don’t realize they have a world-class operation here,” Worrick said. “I can’t say enough about how they are a world-class group. They have all these studies and are recognized by the feds as a premiere group. They are one of only two groups in the state of Wisconsin that have access to certain experimental programming. They are super and they have all these ties to Madison, to Mayo. When we started the radiation oncology program, we thought if we treated 16 to 18 patients a week up here that that would be as much as we do. But there are times we treat as much as 40, 50, 60 people up here. Cancer occurs more as you get older and we’re an older community. That’s why those numbers are like that, so it’s important to have that here.”

While those involved with the Door County Cancer Center realize that a small rural hospital rarely has access to such advanced cancer treatment, the community itself may not realize that.

“Cancer’s one of those things, if you haven’t had to deal with it, you may not even be aware that there’s a cancer center that has all these services in Door County, until you’re faced with that in your life,” Luehring said. “We have had patients come into the cancer center through their primary care physician, and they are like, ‘We didn’t even know this is here.’

“Sometimes patients think, ‘If I want to get the latest and greatest treatment option that’s available I have to go to Madison or Milwaukee or Mayo’ or something like that,” she said. “They are available through the HSHS St. Vincent Regional Cancer Institute, and they are available in Door County. We are able to offer leading edge clinical trials, the latest treatments available through our HSHS St. Vincent Cancer Research Institute. Because the doctors that come to Door County are part of our research program, they are able to offer those things, clinical trials, to patients in Door County. That’s another fabulous option. Smaller communities just can’t offer that kind of clinical trial because the infrastructure that it takes is impossible. So that is another huge benefit.”

The most important piece of equipment for radiation treatment is the linear accelerator, which is used to deliver high-energy x-rays to cancerous tumors.

“Now we’re at that point, 10 years later, it’s time technology-wise to replace the linear accelerator,” said Worrick.

The new linear accelerator was installed in January 2015. Worrick said some patients still had to travel to Green Bay for specialized treatment, but with the upgrade, fewer still will have to make the journey.

“Now, I think that’s going to be cut down to almost zero,” he said.

“That brings the latest generation of technology in radiation therapy services to Door County as well,” Luehring said. “So we will be able to offer the same type of treatment – called image-guided radiation therapy – in Door County, the same thing patients get in Green Bay.”

Luehring points out that it takes dedication and support from many quarters to make this successful partnership work.

“A lot of our patients need services like radiology or lab work, and the hospital’s been a great partner in working with us on that. So they have brought all of those components to the collaboration,” she said. “The other piece that is important, that has come from Ministry Door County Medical Center, is the rest of the medical staff, like the primary care physicians of North Shore. Obviously they are devoted and committed to providing good quality care for patients close to home. They’ve been very supportive of having this resource there as well and have a great working relationship with oncologists coordinating care.

“There are a lot of specialists,” she said. “Cancer care takes a huge team of specialists in order to deliver care. It’s not a one-doctor show. Neurosurgeons, radiologists, pathologists are all very important to the diagnosing and figuring out what stage the cancer is at and the best treatment plan for that patient. We’ve had great support and everybody is really focused on keeping care local for our patients.

“The other group I don’t want to leave out because they are so important is hospital administration. We have such passionate and solid support from Ministry Door County Medical Center in this collaborative effort. It’s certainly the building itself and all the effort and work it took to do that, and the foundation and fundraising, everything that goes on with that. They have been extremely supportive. Not only that, but making sure we get the word out and that people know we have these resources available. I think after a decade, we really have it very fine tuned.”

Philanthropy Built the Cancer Center

Photo by Len Villano.

By Jim Lundstrom

This year marks the 10th anniversary of the Door County Cancer Center, which stands as a testament to the philanthropic nature of Door County.

“It was 10 years ago when we started the campaign for the Door County Cancer Center,” said Mike Herlache, executive director of the Door County Medical Center Foundation. “Before the cancer center was built by the hospital, there was only chemotherapy treatments going on, and even that was being provided in a very small space, one room. All the patients were going to one room for treatment, so there was no patient confidentiality. Sometimes the patients didn’t mind that because they could talk with others, but it wasn’t that great a situation. There was no radiation therapy at that time, so anybody who needed radiation therapy needed to travel to Green Bay or elsewhere. When you’re going through radiation treatments, the last thing you want to do is drive 50 miles or more one way to get that done. So there was a huge need for that.”

So, with the idea of creating a cancer treatment center for the 21st century, the foundation started a campaign to raise funds for the center.

“We put together a $3 million campaign and raised that money within a year to build the current cancer center facility,” Herlache said. “That facility contains 10 chemotherapy treatment rooms. It also has an area that provides radiation treatment, for the first time in the community. It really ended the need to leave Door County for most cancer treatments.”

How in the world did the campaign achieve its lofty goal in one year?

“Because Door County is a wonderful philanthropic place. It really is,” Herlache said. “I always attribute it to the island mentality that we have here. We’re on the Door Peninsula, I understand that. We’re isolated from just about anything else big city-wise, so the people of this community, not only the permanent residents but what I call snowbirds, demanded that our services – not just health care services, but many services in Door County – are big city-like.

It was very important that we have fully integrated health care services, and the community understands that. They stepped up for us numerous times. It’s not just the cancer center.

“Starting in 2001 we actually started what we call Our Legacy of Quality Health Care Campaign at the hospital, and that was to replace and update all the patient care facilities at the hospital,” Herlache continued. “We had 10 years to do that. We actually started with a surgical services addition. The second project was Door County Cancer Center. The third project was the Women’s and Children’s Health Center. And the fourth and final, and the largest project we did, the in-patient services addition, which included brand-new patient rooms and a brand-new emergency room. Altogether, these additions were $40 million. We raised about $11 million of those costs from the community. It’s an incredible story. Whenever I get the chance, I like to tell that story. It’s been an unbelievable last 10 years.”

CANCER FACTS

In 16 years, cancer will become the leading cause of death in the United States, surpassing heart disease, according to a new report from the American Society of Clinical Oncology. The number of new cancer cases is expected to increase nearly 45 percent by 2030, from 1.6 million cases to 2.3 million cases annually.

In Wisconsin from 2006 to 2010, an average of 28,926 residents were diagnosed with invasive cancers each year, and more than 11,000 died of these diseases annually. Males have higher cancer incidence and mortality rates than females, and cancer rates increase with age, most dramatically after age 50. The overall cancer incidence and mortality rates in Wisconsin are similar to rates reported for the nation.

Lung cancer is the leading cause of cancer deaths in Wisconsin, with a yearly (2006-2010) average of 1,591 men and 1,316 women dying from the disease. Cigarette smoking causes the majority of all lung cancer deaths in Wisconsin. More people die from lung cancer than from breast, prostate and colorectal cancers combined. In Wisconsin, lung cancer killed an average of 2,906 residents per year during the five year period 2006 through 2010, and an average of 3,838 new cases of lung cancer were diagnosed each year. More women die each year of lung cancer than breast cancer. The lung cancer incidence rate was 62.0 per 100,000 for Wisconsin, marginally higher than the national lung cancer incidence rate of 61.4 per 100,000.

Cancer is currently the leading cause of death in Wisconsin, with a 2010 mortality rate of 173.7. Heart disease is the second leading cause of death, with a mortality rate of 163.3 that same year. Nationally, heart disease remains the leading cause of death; the 2010 heart disease mortality was 177.2 and cancer mortality was 171.8.

Prostate cancer ranks as the second leading cause of cancer death for men, accounting for 11 percent of male cancer deaths, while breast cancer ranks as the second leading cause of cancer death for women at 14 percent.

Colorectal cancer is the second leading cause of cancer death in Wisconsin residents for males and females combined. Wisconsin males have a higher mortality rate from colorectal cancer than do females.

Source: Wisconsin Cancer Facts & Figures