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Cancer program report at Harlan ARH Hospital

A cancer diagnosis is a frightening experience and while it may be your first instinct to turn to a larger city for such specialized care, many of the same forms of cancer treatment are available a lot closer to home.

Appalachian Regional Healthcare provides oncology (cancer) services delivered with kindness and compassion. As an affiliate of the Markey Cancer Center Affiliate Network, Harlan ARH is your local option for cancer care.

To ensure we provide high-quality cancer care, Harlan ARH established an active oncology program that consists of a multidisciplinary team of healthcare professionals. We work together to increase the quality of services provided to the people of Harlan County and the region.

As part of this commitment, each year a physician member of the oncology/cancer program performs a study to ensure that the treatments being performed in Harlan are in compliance with national guidelines.

This year, I was chosen to perform the study. As a board certified physician in internal medicine and oncology, plus a specialist in various types of cancer cases, the team believed I was the correct choice for the assignment. My residency in internal medicine and fellowship in oncology were completed at East Tennessee State University in Johnson City, Tennessee, so I have a history and familiarity with cancer treatment in the region.

To explain the study, you need to understand some basic information about lung cancer in Harlan County. The American Cancer Society has classified two main types of lung cancer: non-small cell lung cancer (NSCLC), which makes up about 80 to 85 percent of lung cancers, and small cell lung cancer (SCLC), which accounts for about 10 to 15 percent of lung cancers.

Due to the fact that SCLC is the least common of the two, not frequently seen in Harlan, and as a result is not typically discussed during our cancer conferences, SCLC was chosen as the topic of the initial study of our cancer program.

Based on data from the Kentucky Cancer Registry, in 2016, there were 775 people diagnosed with SCLC in Kentucky. As of November 2018, there have been 698 cases recorded for 2017. In 2017, Harlan ARH had 125 patients diagnosed with some type of cancer, but only three of those patients were diagnosed and treated for SCLC. That is 2.4 percent. All three cases were in stage four at diagnosis and not curable, but they were treatable.

We reviewed the treatments provided to those three patients and compared it to the national guidelines from the National Comprehensive Cancer Network (NCCN). This organization promotes continuous quality improvement & recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians & other health care decision-makers around the world.

The results of the study showed that all three patients received treatment and care according to their national guidelines, including having had efficient diagnostic and pre-chemotherapy workups.

By doing this study, it ensures that Harlan ARH is providing quality cancer care that is comparable to other cancer centers nationwide with the added convenience of being close to home.

Kamlesh Sajnani, MD, specializes in oncology at ARH Daniel Boone Clinic in Harlan.