Cancer Resources Meet Grim Demand In Mahoning Valley
YOUNGSTOWN, Ohio -- Consider it an unfortunate case of supply meeting demand. The Mahoning and Shenango valleys offer a variety of resources for treating a range of cancers, but those resources are available to a population that statistically is more prone to cancer than other areas of Ohio or, for that matter, the United States.
The national incidence of cancer rate is 467 per 100,000, the mortality rate 189.9 per 100,000.
By comparison, in Mahoning County the cancer incidence rate is 499 per 100,000, well above both the Ohio and national averages, with Trumbull County posting comparable numbers, reports Vanessa Chamberlain.
Chamberlain is oncology service line liaison for cancer centers affiliated with Humility of Mary Health Partners. Trumbull County numbers are similar, she says. Mortality rates even more dramatically surpass the statewide and national averages.
“We see a lot more cancers [in the Mahoning Valley] than in other places in Ohio and certainly other places in the country,” she says, “and we lose a lot more patients to cancer.”
HMHP operates four cancer centers in Mahoning and Trumbull counties including St. Joseph Cancer Center, Warren, which offers both radiation and medical oncology. Among HMHP’s resources is the Joanie Abdu Comprehensive Breast Care Center, Youngstown, dedicated to the second-most commonly occurring cancer.
According to the cancer profile for 2008 compiled by the Ohio Department of Health, an average of 1,600 invasive cancer cases and 666 deaths occur among Mahoning County residents each year. Of those, 14 cases and three deaths occur among children age 19 or younger.
In Trumbull County, 1,311 invasive cancer cases and 554 deaths occur, with eight cases and one death among children 19 or younger.
Chamberlain points to several potential factors that contribute to high incidence rates in the region, including environmental and socioeconomic factors such as poor diet and lack of exercise.
“All these things that we’re finding increase your chances of getting cancer. A lot of times we’re just not doing as good a job as other areas in eliminating those,” she says. The high mortality rate can be attributed, at least in part, to late diagnoses, which make treatment more difficult.
Advances are being made in both radiation and medical oncology, says Dr. Richard Tokars, radiation oncologist with ValleyCare Health System of Ohio, which has hospitals in Youngstown and Warren. “We’re always in a state where protocol studies are being done to improve the results of the treatment of colorectal cancer, lung and breast cancer. Right now, in terms of radiation oncology, the improvements are a reflection of our advances in technology.”
That includes a treatment known as intensity modulated radiation therapy, a more advanced form of radiation treatment than conventional radiation therapy where the radiation is pinpointed to minimize side effects. In medical oncology, or chemotherapy, the improvements are in advanced combinations and targeting agents.
However, Tokars adds, even the advances in both radiation and medical oncology are “baby steps” in addressing cancer. “If you really want to take some big steps, if you want to improve the cure rate, the answer would be early detection.”
Both Trumbull Memorial Hospital and Northside Medical Center have dedicated breast centers and digital mammography units at five locations with no appointment required, says Dr. Darla Habosky, ValleyCare lead oncology therapist. The system also offers a breast cancer patient navigator to help patients though the first step of the process, and a female diagnostic radiologist who specializes in breast diseases at Northside.
The Hope Center for Cancer Care provides diagnostic and treatment resources for both cancer and blood disorders at offices in Boardman and Howland.
“Our big advantage is we are partnered with the US Oncology Network,” a network of more than 2,500 physicians and practices, says Crystal Shells, senior oncology liaison. Physicians at the two sites, which also work with area hospitals, might see 20 to 30 patients each day, she says. In some cases the center is getting patients from as far as Stark County.
The center also brings in speakers, including a national speaker to discuss the various modes of treatment at events set for Oct 29 and 30, and is active in raising money for the Silver Lining fund to provide services to the increasing number of patients who can’t afford to pay. “It’s getting worse,” Shells says.
At Jameson Health System in New Castle, Pa., several hundred cancer patients are seen annually and several thousand seen, reports Dr. Steve Wilson of Jameson Radiation Oncology. Cancer types appear similar to national statistics, “with the exception that lung cancers seem more prevalent here, in my experience, than other regions related to the higher smoker rate of Lawrence County residents,” he says.
Therapies Jameson Radiation Oncology offers include IMRT and image guided radiation therapy, Wilson reports. “We also recently upgraded to ‘RapidArc’ treatment,” a type of rotational arc treatment that cuts actual treatment time from 15 to 20 minutes to as little as three minutes, he says.
Last year, Sharon Regional Health System’s Cancer Care Center had 22,000 patient visits for medical oncology services and 6,872 patient visits for radiation therapy, reports Jessi McCloskey, director. Located in Hermitage, the center offers chemotherapy and radiation therapy, advanced prostate cancer treatment and biological response modifiers, along with other services
According to Sharon Regional’s recent community health needs assessment, deaths from cancer are second only to heart disease. “Mercer County’s rate per 100,000 from cancer is 288.1, as compared to a rate of 226.8 for Pennsylvania and 187.3 for Ohio,” McCloskey says.
“Smoking is of particular concern” because the needs assessment identified it as one of the top four priorities Sharon Regional will address over the next three years, McCloskey says.
Salem Community Hospital offers a full range of services for both diagnosis and treatment of cancer, says Michele Hoffmeister, director of public relations. The medical imaging department, in addition to digital X-rays and mammography, ultrasound and nuclear medicine, offers 3-D dual-128 slice CT scanner which provides exams at twice the sped of traditional CT scanners.
“Virtual colonoscopy, an alternative to traditional colonoscopy, and low-dose CT lung screening are two of the newest uses of this technology, which allows physicians to diagnose cancer in its earliest stages, when it is most treatable,” Hoffmeister says. “This past year, three of the nearly 100 patients screened for lung cancer at Salem Community Hospital were diagnosed with early and potentially curable lung cancer,” she says.
Among children, the most commonly occurring cancers are leukemia, lymphoma and brain tumors, says Dr. Jeffery Hord, director of the Childhood Cancer and Blood Disorders Center at Akron Children’s Hospital, which has a Boardman campus and other sites nearby. While some medical situations, such as Down syndrome, carry greater risk of cancer, in the vast majority of cases the cause among children is unknown.
When it comes to treating children with cancer, there are good sides and bad sides, Hord says. The cure rate for even rare tumors is around 85%, and is even higher for Hodgkin-type lymphoma, 95%. “So the outlook for a child with cancer is quite good,” he says. Part of the reason for that cure rate is children can tolerate higher doses of chemotherapy than adults.
However, because of how rare some tumors are, finding standard pathways to base treatment can be difficult, he adds. Since Akron Children’s works within a network of pediatric centers funded by the National Cancer Institute, it has access to all of the latest treatment protocols across the network.
One area of particular concern to health-care professionals is the rise in youth smoking. “For a while the trend was moving down and it is going back up,” HMHP’s Chamberlain says. “You have to do it for a few years before you end up in the cancer center, but the age of the lung patient is coming down. We’re seeing a lot of younger patients and it’s very alarming.”
The problem of peer pressure is a stronger on a teenager than their parents, ValleyCare’s Tokars says. “They look at it as [smoking is] not going to kill them right now,” he says.
Jameson’s Wilson agrees smoking is an issue among young people, although he and other experts note that skyrocketing childhood obesity rates will be linked to similarly accelerated cancer rates in just a few decades. “This is obviously related to decreased average amount of activity during the day,” he says, “increased watching of television, computer monitors, game consoles and mobile devices, increased in social media, etc.”
EDITOR'S NOTE: First published in the October edition of The Business Journal.
Copyright 2013 The Business Journal, Youngstown, Ohio.
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