Cancer Institute Annual Report 2022
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2022 Director’s Letter
CONTENTS
provided senior-level leadership and support to the Cancer Institute for more than 20 years, announced his retirement. Renee Hawk, Vice President of the Cancer Institute, retired in June 2022. Both individuals were an integral part of the growth and development of the Cancer Institute. I am happy to report that their positions were filled internally with experienced and competent administrative leaders. Dr. Lisa Duncan is the new Senior Vice President for the Centers of Excellence, which includes the CI. Susan Stinnett, MBA, RT, was selected as the Executive Director of the CI. Other leadership changes in the CI include Natalie Ellis, BSN, RN, OCN, who is the new Clinical Director, and Brett Miller, M.S., DABR, MBA, the Director of Radiation Oncology and The Breast Center as well as the Chief Medical Physicist. We look forward to working and growing with the new leadership team. I hope that each of you enjoy this report outlining some, but certainly not all, of the activities and accomplishments of the Cancer Institute in 2022. We look forward to 2023 and remain focused on our mission to serve through healing, education, and discovery.
expansion of molecular and genetic testing. These technologies are revolutionizing and personalizing patient care from diagnosis to determining the most effective treatments to predicting prognosis. The CI leadership and clinical team are partnering with several testing companies to ensure appropriate and accessible testing is available for patients served by the CI providers. Despite the challenges brought about by COVID, University Health Systems, Inc. (UHS), and the UT Graduate School of Medicine moved forward with applying to the Accreditation Council for Graduate Medical Education (ACGME) for a fellowship in medical oncology. The application was approved, and the first two fellows began in June 2022. This was another milestone in the UHS mission to train specialists who will hopefully remain in our region for the future delivery of health care. In 2022 UHS and the Cancer Institute began the process of developing a new strategic plan which will provide direction for the next five years. The Cancer Institute kicked off the process with a one-day retreat in August 2022 that included all cancer specialists and administrative leadership from CI managers to UHS senior leaders. Over the remainder of 2022, the CI strategic plan was developed, refined, and aligned with the hospital plan. In 2023 the CI leadership will begin rolling out this new plan. As with all things, change is inevitable. 2022 brought changes in leadership for the Cancer Institute. Dr. Steve Ross, Senior Vice President of Strategic Development, who had
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Director’s Letter Cancer Committee Chair’s Report Helping Blood Cancer Patients Patient Story - Paul Patient Story - Betty Here We Grow Again Music Therapy Palliative Care Bettie and Oscar Bragg Cancer Research
(chemotherapy, immunotherapy, targeted therapies, and supportive care). The development of the regimens included a team of physicians, pharmacists, nurses, and IT analysts who collaborated for 18 months to accomplish this task. The implementation phase involved all staff who serve a patient undergoing treatment in any capacity. During the entire process, the safety and care of patients remained the number one priority and focus for our team while trying to maximize efficiency. The Transplant and Cellular Therapy (TCT) program, which launched in November 2021 saw the number of patients seeking transplant services exceed projected volumes. Many were thankful to have access to these services right here in East Tennessee. By the end of 2022, the TCT program had completed 25 transplants, was planning the first chimeric antigen receptor (CAR) T-cell therapy treatment, and had completed agreements to offer a clinical trial for tumor-infiltrating lymphocytes (TILs). CAR-Ts and TILs are both emerging cellular therapies in which the patient’s own immune cells are treated and infused back into the body to fight cancer. The TCT program is the only program offering transplant and cellular therapy services in the East Tennessee region, thus relieving patients and families of the burden and expense of traveling outside the area for these types of treatments. In addition to the advancement of the TCT program, the Cancer Institute remains on the forefront of the
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with expanding regional access, providers, and facilities to better serve those in our community. By the end of 2022, the Cancer Institute had completed renovations that added 10,000 square feet of new space to the Cancer Institute on the main campus, was preparing to open a new medical oncology practice and chemotherapy infusion center at the Halls Regional Health Center, had completed plans for a new Cancer Institute satellite in Alcoa, and had recruited four new medical oncologists and supporting staff to the CI team. Another major accomplishment in 2022 was the implementation of the third and final phase of the oncology electronic medical record or EMR. This last and most challenging phase revolved around the development and launch of more than 500 treatment regimens
Welcome to the 2022 Cancer Institute Annual Report. Finally, 2022 was a year that things began to return to normal after more than two years of focusing on COVID and precautions to keep our patients, their families, and the Cancer Institute (CI) team safe while continuing to provide high- quality care to those facing a cancer diagnosis. As 2022 progressed, volumes of patient visits, surgeries,
Endowment 2022 Cancer Statistics Hematology Oncology Fellowship
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chemotherapy, and radiation treatments rebounded to pre-
Sincerely,
COVID volumes as patients resumed screenings and physician visits. This letter includes highlights from 2022 and several articles in the report will provide more details of the ongoing efforts and accomplishments of the Cancer Institute team. In preparation to meet the growing oncologic needs in our service region, the Cancer Institute moved forward
CONNECT WITH US
John L. Bell, MD, FACS, FSSO Director Cancer Institute, Surgical Oncologist
UTMedicalCenter.org
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Cancer Committee Chair’s Report
highlights just a few of the many leaders and influencers that have invested time and resources to ensure our success. It is also worth noting there are many new, up-and- coming, talented leaders that are similarly dedicated to growth and success of the Cancer Institute. I have been honored to serve as the CCC chair for the last five years and look forward to the great work that Dr. Lloyd, and the entire Cancer Committee, will accomplish.
understanding community needs in our region related to cancer screening, and researching best practices to improve cancer outcomes. She began her career at the Cancer Institute in 2015 and has distinguished herself as a leader in our Cancer Institute and in our region. Dr. Schmocker is a surgical oncologist with a practice focused on laparoscopic and robotic liver and pancreas surgery. Beyond his surgical expertise, he brings a passion for cancer research, improving disparities in cancer care, and improving quality outcomes in all aspects of cancer care. As an organization, we have experienced many talented, diligent, and passionate leaders that have guided the Cancer Institute from its early years to its current stature and regional impact. This article
Jerry Crook, MD, is the Senior Vice President for the Physician Enterprise, which includes almost all of the Cancer Institute physicians. He reports to Keith Gray, MD, MBA, who is the Executive Vice President and Chief Medical Officer. Steve Clapp is the Senior Vice President for Strategic and Business Development. He reports to Joe Landsman, CEO. This talented and inspirational team of leaders are aligned in mission and vision to support the continued growth, innovation, and regional impact of the Cancer Institute. At the level of the Clinical Cancer Committee (CCC), Jill Lloyd, MD, MPH, has been named the new CCC Chair and Ryan Schmocker, MD, FACS, the new Cancer Liaison Physician. Dr. Lloyd is a breast cancer surgeon with a passion for improving access to care,
career as a radiation therapist. She was recruited to the Cancer Institute in 2016 as the Director of Radiation Oncology and the University Breast Center. In June 2022 she was selected as the Executive Director of the Cancer Institute. She brings a broad understanding of delivering high-quality oncology patient care, a strong financial background, and is a gifted communicator. 2022 was also the year that Steve Ross, PhD, announced his retirement as Senior Vice President of Strategic Development. His career at UT Medical Center spanned four decades. He oversaw several important initiatives of the Cancer Institute including facilities expansion and the development of our clinical trials program. Of the many projects Dr. Ross oversaw over his tenure, the key highlights include the elevation of the Cancer Institute to a Center of Excellence (COE) in 1999, developing the Cancer Imaging and Tracer Development program in 2003, the development and designation for the Brain and Spine Institute in 2004, and the development of the Stereotactic Radiosurgery Program in 2005. We are grateful to Dr. Ross for his years of dedicated service. To accommodate our organizational growth, the medical center has divided Dr. Ross’ responsibilities into three leadership categories. Lisa Duncan, MD, is the Senior Vice President for the Centers of Excellence, which includes the Cancer Institute. She reports to James Shamiyeh, MD, who is the Executive Vice President of Clinical Operations.
Cyberknife program, and the development of the Transplant and Cellular Therapy Program. She also was instrumental in developing our hospital-wide Palliative Care Program, creating the Integrative Health Program, overseeing the expansion of oncology services at regional community centers, and was instrumental in the transition of cancer care from paper charting to fully electronic health records. Under her leadership, the Cancer Institute moved from the main hospital to Medical Building D in 2003 and then to its current location in Medical Building F in 2012. As of 2022, the Cancer Institute building is fully dedicated to cancer care including navigation, tumor registry, social work, dietician support, clinical trials, and numerous multidisciplinary tumor board conferences. She had many additional accomplishments including recruiting talented staff and providers, expanding quality standards, and providing necessary services to ensure that almost all aspects of cancer care can be provided here in East Tennessee. Few individuals have had a more lasting impact on the Cancer Institute than Renee. Fortunately, despite her official retirement, she remains active in the Cancer Institute, especially in strategic planning and community expansion. The Cancer Institute was fortunate to identify an excellent and very capable replacement for Renee with the nomination of Susan Stinnett, RT, MBA, as the new Executive Director. Susan has been in health care leadership since 2007. She began her
Sincerely,
James McLoughlin, MD 2022 Clinical Cancer Committee Chair, Surgical Oncologist
Looking back on 2022, The University of Tennessee Cancer Institute again noted increased growth, expanded services, and steady recruitment of providers and staff. 2022 was a year of returning to routines, reengaging regular cancer screening, and expanding access. 2022 was also a year of transitions of leadership. After a career of 23 years as a Cancer Center leader, Renee Hawk retired as Vice President of the Cancer Institute. Renee oversaw and led remarkable growth and a transition of the Cancer Institute from 1999 through 2022. The Cancer Institute was first designated as a Center of Excellence in 1999 at the time that Renee was appointed as Administrative Director. She was then promoted to Vice President of the Cancer Institute in 2005. During her tenure, she oversaw the creation of the University Cancer Specialists and University Gynecologic Oncology practices, the initiation of the
Renee Hawk Vice President, Cancer Institute (retired)
Susan Stinnett, RT, MBA Executive Director, Cancer Institute
Steve Ross, PhD Senior Vice President of Strategic Development (retired)
Steve Clapp Senior Vice President of Strategic Development
Jay Crook MD, JD, FACC Sr. Vice President, Physician Enterprise & Chief Medical Officer
Lisa Duncan, MD Sr. Vice President, Centers of Excellence
Ryan Schmocker, MD Surgical Oncologist, Assistant Professor
Jill Lloyd, MD, MPH Breast Surgeon, Section Chief, Breast Surgical Oncology
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Healing Patients Through Their Whole Journey The program offers stem cell transplants and other cellular
If you have a blood cancer or disorder, like leukemia, lymphoma, or myeloma, your doctor may have recommended a stem cell transplant. That would mean traveling to Nashville or Atlanta for treatment. But now the new Transplant and Cellular Therapy (TCT)
therapies that are designed to help the immune system fight cancer, like: • Chimeric antigen receptor T-cell (CAR-T) therapy • Immune effector cell therapy Filling a Critical Need for East Tennessee TCT center physicians will work closely with other local physicians who specialize in treating blood cancers to identify and refer patients who will benefit from these treatments. Even after the patients’ treatment programs end, the medical center’s care team will continue to collaborate with the patient’s referring primary physician. “Our goal is to maintain the patients’ continued well-being and assess the need for any future treatments,” said McCaul. The TCT center will fill a critical need for East Tennessee patients with blood disorders and cancers. Dealing with a diagnosis like this is an already stressful experience. Having the center in Knoxville will help relieve the stress of being away from home and loved ones, which goes a long way toward helping patients heal.
on the fourth floor of the medical center’s Cancer Institute, will include both inpatient and outpatient services. With expert physicians, nurses, registered dietitians, social workers, and many other behind- the-scenes professionals, patients will receive the highest level of care throughout their entire cancer treatment journey at the TCT center. Raj said, “It’s a very efficient and meaningful way to operate, with all the levels of care for the patient in the same place.” In addition to large, comfortable inpatient rooms, the TCT floor will also include a stem cell collection area. There will also be a cell processing lab where harvested stem cells are stored in liquid nitrogen until they are ready for a patient’s use.
program is open at The University of Tennessee Medical Center.
Kelly McCaul, MD, acts as the program’s medical director and Renju V. Raj, MD, is the transplant and cellular therapy physician. “The thing that excites me the most about this is being able to bring stem cell transplants to patients in our area,” said McCaul. “This program will change the way physicians treat blood cancers and disorders in our region.” Treating Patients at One Convenient Location The state-of-the-art facility, located
Helping Blood Cancer Patients
Right Here at Home Transplant and Cellular Therapy services are now available at The University of Tennessee Medical Center
Stem Cell Transplants Help Patients With:
CAR-T Advanced Cellular Therapy Helps Patients With:
Non-Hodgkin’s Lymphoma B-Cell Lymphoma Follicular Lymphoma Mantle Cell Lymphoma Acute Lymphoblastic Leukemia
Leukemia Non-Hodgkin’s Lymphom a Multiple Myelom a Myelodysplastic/ a a
Myeloproliferative Disorders Certain Types of Solid Tumor Other Blood Disorders Like Aplastic Anemi a
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doing well. “I have to get used to a new normal with my digestive system,” he said. “That’s the biggest adjustment. But there’s no cancer, so that’s all that’s important.” Today, Paul stresses the importance of preventive maintenance and following your physician’s recommendations on the frequency of colonoscopies. “Health-wise, it’s made me more aware of what I eat. I feel healthier, better. It’s made me closer to my wife — I mean, talk about for better or for worse. It’s like God was telling me ‘you’ve got a job to do.’ And now I have an opportunity to tell people about it.” Thank you for sharing your story, Paul, and we are grateful for your positive outcome. Please talk to your physician if it’s time to schedule a colonoscopy, because as Paul’s story illustrates, having one could save your life.
ready to leave. I want to be here for my kids. It upset me at first, and there were lots of prayers, but it all moved so fast.” As it happened, Paul’s wife’s aunt had worked with colorectal surgeon Dr. Andrew Russ for years and assured him that he would be in good hands. In the surgery, Dr. Russ removed a portion of Paul’s lower colon, 20 lymph nodes, and a 6-cm-sized tumor. Fortunately, because of the success of the surgery, Paul learned shortly thereafter that no radiation or chemotherapy would be required. “Dr. Russ and the whole staff did a great job,” Paul said. “Everything they said about the process and the surgery was true. They were efficient, explained everything every step of the way, and made me feel at ease.” Paul missed two weeks of work, after the surgery and is
Patient Story: PAUL
During National Colorectal Cancer Awareness Month in March 2023, we had the opportunity to share a patient story on Paul, a VP at a home improvement company, husband, father to six kids, and cancer survivor. Paul’s journey with cancer began in December 2022 when he felt a twinge in his side while at work. He took a pain reliever and thought it would go away. However, the pain worsened, and he ended up leaving work early. At home, his wife and mother-in- law encouraged him to go to the emergency department (ED). There, he was diagnosed with colitis, an inflammation of the inner lining of the colon which can increase the risk of colon cancer. By coincidence, Paul had an appointment for his first-ever colonoscopy the following week. Soon after that procedure, the gastroenterologist informed him that he had Stage II colon cancer. Having experienced no symptoms until the visit to the ED, Paul was stunned. The next three weeks were consumed with bloodwork, multiple MRIs and CT scans in preparation for surgery to remove the cancer. “I was so consumed with that, I didn’t have too much time to get too panicked,” Paul said. “No one wants to hear the word cancer. I wasn’t
Paul accepting the President’s Club Certificate of Excellence from American Home Improvements owner Mark Sims.
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Patient Story: BETTY
The surgery successfully removed the cancer, and Betty received chemotherapy treatment for four months afterward. “It was hard — I had nausea and just a general feeling of being not well,” she said. “But I gutted it out. I had to do it. We had to follow the protocol.” It was a long road to recovery, just trying to get her strength back. “I didn’t really feel great until about nine months after,” she said. “It took a long time before I quit thinking about it. I kept thinking the cancer might come back after five years. Now, days and weeks go by that I don’t even think about it.” Betty thanks Dr. Bell and all of the nurses who treated her so kindly during her cancer journey and notes that she had a lot of support from family and friends as well. “I think that I found some inner strength that you find when you need it,” she said. “But now I can say that I feel blessed to be a 30-year cancer survivor.” “Betty is an incredible and strong woman. She was a ‘model patient’ throughout her challenging cancer journey. She tolerated chemotherapy, radical surgery, and additional chemotherapy after her operation. We were open, honest, and direct with each other and knew we were in rare disease treatment territory. I am grateful she allowed the team at The University of Tennessee Medical Center Cancer Institute the opportunity to cure her of this extremely rare cancer. I am so happy she continues to thrive and lead a happy, healthy, and productive life 30 years later. She has even become a pickleball champion!” - Dr. Bell
stop the cancer from growing, Dr. Bell told Betty that surgery would be necessary. He recommended that they follow a new protocol published by Dr. Paul Sugarbaker, considered one of the world’s leading peritoneal mesothelioma and peritoneal cancer experts. They discussed the possibility of Betty being treated directly by Dr. Sugarbaker, but his office was in Washington, DC. That would’ve meant staying in DC for four months — without her husband — and then traveling back every month for follow-up treatments. “Dr. Bell felt they could handle my case at UT Medical Center,” Betty said, “and I believed they could do what they said they could do. He shared everything with me, explained what we could expect, and how everything was going to go. It was great to be here with my friends and family.”
Betty first learned that something was wrong when, after undergoing a hysterectomy, the surgeons told her that they’d found a jelly-like substance all over her abdomen. “It was such a confusing, busy time,” she said. “We didn’t even know what type of cancer it was or what the treatment would be. It was stressful not knowing.” Once the pathology reports from her surgery were assessed, the cancer was diagnosed as mucinous cyst adenocarcinoma of the appendix with pseudomyxoma peritonei. She consulted with Dr. Bell from the Cancer Institute at UT Medical Center and asked him to review the results. He concluded that Betty had Stage 3 appendiceal cancer, and together, they discussed a treatment plan.
After she participated in a clinical drug trial that did not
When Betty Collins was treated for cancer 30 years ago, there was a time she feared she wouldn’t be able to maintain the active lifestyle that she and her husband enjoyed. Now married for 48 years, they love playing pickleball, fishing, and traveling together, and Betty credits Dr. John L. Bell and UT Medical Center with her long-standing cancer survivor story. Betty first learned that something was wrong when,
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Here We GROW Again
being recruited in medical oncology, surgical oncology, GYN oncology, and radiation oncology for 2023 and beyond. The CI is committed in our focus to ensure access for patients seeking cancer care in our region. Along with our administration and physician partners, we will continue to identify and address needs for space, services, and manpower to provide accessible, high-quality care to those that entrust us with their oncology care.
new physicians to provide patient care. University Cancer Specialists hired four new medical oncologists in 2022 which included Dr. Sarah Jenkins and Dr. Clark Cutrer (main campus), Dr. Ardalan Davarifar (main campus and Halls RHC) and Dr. Felicia Wheeler (Maryville, Alcoa, and Lenoir City). Along with the new physicians, new nurse practitioners, medical assistants, and other supporting staff were added to our CI team. Additional cancer specialists are
CI facility which will combine the Blount oncology services into one location. Plans for the new facility were developed and completed in 2022 with construction beginning in early 2023. Currently, the completion date for the Blount County UTMC CI facility is projected for the first quarter of 2024. In addition to space, cancer specialists and support staff are also required to meet the increasing demand for services. The CI was fortunate in 2022 to recruit several
While the COVID-19 pandemic slowed progress on many things, the Cancer Institute (CI) leadership at The University of Tennessee Medical Center (UTMC) remained focused on plans to expand capacity and meet the estimated growth of cancer volumes in our region. According to the Healthcare Advisory Board, the number of new cancer cases are projected to increase by 14% over the next 10 years. With the CI already experiencing some challenges meeting the demand for cancer services, it was imperative to develop strategies to address and meet the oncology needs of those in our community. During 2022 the CI initiated several construction projects to increase space to improve access for our patients and services. These expansions are both on the main campus and in our region. The CI was able to renovate 10,000 square feet of space in our main campus facility when the Advanced Orthopedic Center moved to their new facility across Alcoa Highway. This first phase of expansion
Blount County Cancer Institute projected to open in Q1 of 2024.
Lenoir City, the CI made plans to open a medical oncology clinic and a chemotherapy/infusion center in the new Halls RHC. The decision was made to also open a third breast center at Halls to provide access and greater convenience for women seeking screening mammography. Construction of this space occurred in 2022 and the new location opened in January 2023. In Blount County, the CI maintains two medical oncology clinics and chemotherapy/infusion centers, one in Maryville and a second location in Alcoa. The expanding demand for services at the two locations resulted in a plan to build a new
allowed the CI to increase exam rooms, phlebotomy space, chemotherapy/infusion chairs, as well as offices for new physicians and services such as the Transplant and Cellular Therapy Program. The second phase beginning in 2023 will provide further expansion for chemotherapy/infusion services and additional space for the oncology pharmacy, which mixes medications used in both inpatient and outpatient oncology areas. In 2022 the CI initiated two plans to increase regional access to oncology services. Like the UT Medical Center Regional Health Centers (RHC) in Sevierville and
Clark Cutrer, MD Medical Oncologist/ Hematologist
Felicia Wheeler, MD Medical Oncologist/ Hematologist
Ardalan Davarifar, MD, PhD Medical Oncologist/ Hematologist
Sarah B. Jenkins, MD, PhD Medical Oncologist/ Hematologist
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Music Therapy A New Option for Healing and Comfort
In early 2008 the Cancer Institute introduced a new service to patients, families, providers, and other health care professionals at The University of Tennessee Medical Center. This emerging medical specialty was palliative care. Palliative care is provided at the time of diagnosis of a serious, chronic illness and is used concurrently with curative or life- prolonging treatment. In 1990 the World Health Organization recognized palliative care as a distinct specialty dedicated to relieving suffering and improving quality of life for patients with life- limiting illnesses. In 2006 palliative care became a board-certified subspecialty of medicine in the United States. As part of the patient’s care team, palliative care providers collaborate closely with other specialists to address symptoms and treatment side effects, as well as social, emotional, and spiritual concerns that arise during the patient’s illness. Most importantly, the goal of the team is to provide each patient with Palliative Care Supporting Patients and Families During Serious Illnesses
The program has also been engaged in the educational mission of the medical center, offering clinical rotations for medical students, residents, and nurse practitioner students. In 2022 the Department of Medicine in conjunction with UPC and UT Home and Hospice Care established a one-year ACGME-accredited fellowship in Hospice and Palliative Medicine under the direction of Dr. Adam Tyson, Medical Director of UPC. The fellowship will foster the development of a diverse group
individualized care that focuses on quality of life and aligns with their values and wishes. University Palliative Care (UPC) was established at UTMC with two part-time physicians and one nurse practitioner. This small team led the development of the program with support from the medical center and Cancer Institute administration. Being a new and relatively unknown specialty, a great deal of effort was placed on educating providers, other health care professionals, and
music and various elements of music. Research has shown that music therapy can ease pain and discomfort, manage feelings of stress or anxiety, enhance creative expression, and promote positive coping strategies. To benefit from music therapy, no previous musical experience or talent is required. Music therapy sessions may include playing or learning to play an instrument, writing songs, singing, relaxation exercises or simply listening to live music. Music therapy is offered free of charge to cancer patients and families in both outpatient and inpatient care. Holly also works closely with the medical center’s palliative care team to identify and serve the needs of the patients under their care. As the benefits of music therapy are experienced and observed, interest in expanding the reaches of the program is being considered. Since joining the medical center, Holly has brought peace, comfort, healing, and joy to many patients and families as evidenced by the positive feedback and numerous notes of appreciation received. Members of the health care team also look forward to Holly’s visits and are uplifted by her smiling face and beautiful singing. As Dr. Adam Tyson, Medical Director of University Palliative Care, said, “Music therapy is a gift, but Holly Solis is a treasure.”
The University of Tennessee Medical Center Cancer Institute has been on the forefront of introducing and offering complementary and integrative services beginning with pet therapy in the early 1990s. The pet therapy program was initiated in conjunction with Human-Animal Bond in Tennessee (HABIT), a program supported by The University of Tennessee College of Veterinary Medicine along with community volunteers and private veterinarians in the region. In 2003 massage therapy was added to the services offered at the Cancer Institute. Since that time, the Integrative Health program has continued to expand to include services such as acupuncture, Reiki, yoga, and the most recent addition of music therapy. The Music Therapy program is led by Holly Solis, a board-certified music therapist. Holly grew up in a family saturated with musicians and was captivated by music at an early age. Her interest and talent continued to grow over the years. Holly went on to graduate from Berklee College of Music in Boston where she majored in music therapy. Holly joined the Cancer Institute as a music therapist in 2020. Music therapy focuses on enhancing the well-being of patients and families who are dealing with cancer by supporting their physical, emotional, psychological, and spiritual needs through live
“You being at my mother’s side playing beautiful music was such a blessing. It made everything a lot easier for us.” - Family Member “No thanks could ever be enough. We are going through yet another, not so welcomed journey. You took us off our path, to a heavenly, peaceful path with your voice and instrument. For that, we will forever be grateful.” - Family Member “Here at The University of Tennessee Medical Center, we have a reputation for being innovative and a leader in all things patient care related, and music therapy for our patients and team members is simply another way that we demonstrate our commitment to providing the best in patient and
of graduates who can succeed in clinical, educational, or academic roles in the scope of palliative medicine. The mission of University Palliative Care is to compassionately serve patients and families at any stage of a serious illness in a way that honors the mind, body, and spirit. As the program celebrates its 15th anniversary, many providers, patients, and families can attest to the remarkable difference that the program has made in the delivery of compassionate and affirming patient-centered care at UTMC.
families on the scope and benefits of palliative care. Since their humble beginnings in 2008, the UPC team has grown to include three full- time physicians, 14 advanced practice providers, a social worker, a chaplain, and a music therapist. While the service only offered inpatient consultations originally, the program has expanded to offer full-time outpatient services in the Cancer Institute for patients and families going through the cancer journey. In 2022 the UPC team cared for 2,590 patients in the hospital and had 1,886 patient encounters in the outpatient clinic.
team member care.” - Chaplain Ben Lewis
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Bettie and Oscar Bragg Cancer Research Endowment
PI: Laura Enomoto, MD, Assistant Professor, Department of Surgery Title: Al-Enabled Robot for Genetic Risk Assessment Education in Colorectal Cancer Patients: A Pilot Study Grant Award: $40,000 PI: Joseph Jackson, PhD, Assistant Professor, Department of Medicine Title: Treatment of murine GBM using an oncolytic HSV engineered to improve immunogenic tumor destruction Grant Award: $40,000 PI: Kristopher Kimball, MD, Associate Professor, Department of Obstetrics and Gynecology Title: Clinical Recommendations for Adult HPV Vaccination: Exploring Patient and Provider Perspectives Grant Award: $40,000 PI: Jillian Lloyd, MD, MPH, Assistant Professor, Department of Surgery Title: Understanding the negative impact of adverse childhood experiences (ACEs) on breast cancer treatment complications: exploring mechanisms and moderators to inform future interventions for high- risk breast cancer patients Grant Award: $20,000 PI: Ashton Brooks, MD, Assistant Professor, Department of Surgery Title: The Impact of Patient Education and Pain Management Pathways on Opioid Utilization and Patient Reported Outcomes for
PI: John L. Bell, MD, Professor, Department of Surgery and Director, UTMC Cancer Institute Title: TARGET - healTh Assessment pRoGram via mobilE ouTreach Grant Award: $40,000 PI: Stefanos Boukovalas, MD, Assistant Director, Department of Surgery/Division of Plastic and Reconstructive Surgery Title: The Impact of Comprehensive Lymphedema Treatment on Clinical Outcomes, Quality of Life and Financial Toxicity: A Prospective Study in Diverse Oncologic Population. Grant Award: $26,500 PI: Jonathan Boone, MD, Assistant Professor, Gynecologic Oncology, Department of Obstetrics and Gynecology Title: Use of a Fasting Mimicking Diet in Patients Undergoing Chemotherapy for Gynecologic Malignancies Grant Award: $27,200
Cancer Institute Endowment Grant Awards Funding Year 2022 Cycle 3 PI: Larry Kilgore, MD, Professor and Chairman, Department of Obstetrics and Gynecology, Division Director, University Gynecologic Oncology Title: Dysregulation of whole-body metabolism in ovarian cancer Grant Award: $40,045 PI: Joseph Jackson, PhD, Assistant Professor, Department of Medicine Title: Induction of Anti- Glioblastoma Tumor Immunity Using Oncolytic HSV Grant Award: $40,000 PI: Gregory Low, MD, Assistant Professor, Department of Surgery Title: Utility of personalized cell- free circulating tumor DNA assay for identification of response to total
In 2015, under the leadership of Becky and Steve South, an initiative to create our first cancer research endowment began. This impactful initiative culminated with the medical center’s “An Evening in Orange” event on April 16, 2016. Now named the Bettie and Oscar Bragg Cancer Research Endowment, and through the generosity of hundreds of donors, more than $5 million was given toward this impactful initiative. We are truly grateful to the generous donors for their investment in cancer research on our campus. The Bragg Cancer Research Endowment (CRE) funds meaningful cancer research on the campus of the medical center and the UT Graduate School of Medicine. The first funds from the CRE became available for distribution in 2020, following an application and peer- reviewed process. Three research grants were awarded in 2020 and since then, 18 grants totaling $561,953 have been funded (see accompanying list of grantees).
Cancer Research Endowment Grant Awards Funding Year 2020 Cycle 1 PI: Jillian Lloyd, MD, MPH, FACS, Assistant Professor, Department of Surgery, Division of Surgical Oncology Title: An Interdisciplinary Approach to Reducing Health Disparities for Low-Income Appalachian Women with Estrogen-Positive Breast Cancer Grant Award: $40,000 PI: Laurentia Nodit, MD, Professor, Department of Pathology Title: Oral microbiome changes in cancer therapy-induced oral
neoadjuvant therapy Grant Award: $38,316
PI: Dustin Osborne, BS, MS, PhD, Associate Professor, Department of Radiology Title: Radiolabeled fluconazole for differentiation of fungal infection
PI: Eric R. Carlson, DMD, MD, EdD, FACS, Professor and
mucositis: a pilot study Grant Award: $40,000
Kelly L. Krahwinkel Endowed Chair, Department of Oral and Maxillofacial Surgery Title: Characterizing a Unique Mechanism as a Potential Therapeutic Agent in Head and Neck Squamous Cell Carcinoma Using Metformin Grant Award: $20,000 PI: Dustin Osborne, BS, MS, PhD, Associate Professor, Department of Radiology Title: Pilot Study to Determine PET/ CT Extravasation Patient Impact and Patient Rescan Criteria Grant Award: $20,000
PI: Larry C. Kilgore, MD, Professor and Chairman, Department of Obstetrics and Gynecology, Division Director, University Gynecologic Oncology Title: Developing a Coordinated Model to Increase HPV Vaccine Education, Recommendations and Uptake Grant Award: $20,000
from malignant disease Grant Award: $9,902
Total: 128,263
Cancer Institute Endowment Grant Awards Funding Year 2023 Cycle 4 PI: Manasi Balachandran, PhD Title: Development of Novel Chimeric Antigen Receptor Macrophages (CAR-M) for Light
Breast Surgery Patients Grant Award: $20,000
To support the work of the researchers and make a gift to the CRE, please scan the QR code.
Total: $100,000
Total: 200,000
Cancer Research Endowment Grant Awards Funding Year 2021 Cycle 2
Chain Amyloid Clearance Grant Award: $40,000
Total: $133,700
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The UT Medical Center Cancer Institute Quality Measure Performance Rates
CANCER STATISTICS 2022
2022 Transplants 21 Autologous Transplants 4 Allogenic Transplants
2022 Cancer Institute Conference Presentations
American College of Surgeons Commission on Cancer (CoC) Quality of Care Measures The CoC develops quality measures and requires all CoC-accredited programs to treat cancer patients according to these nationally accepted standards. The University of Tennessee Medical Center has been CoC accredited since 1980. The performance of an individual program can be measured against the data from all other CoC-accredited programs (1500 cancer centers in the US) through the National Cancer Database. MadjRX Melanoma adjuvant systemic therapy was administered within 6 months of surgery or recommended for eligible patients with Stage IIIB-D resected melanoma BCSdx First therapeutic breast surgery in a non-neoadjuvant setting is performed within 60 days of diagnosis for patients with AJCC clinical stage I-III breast cancer GCTRT Neoadjuvant chemotherapy and/or chemo-radiation is administered within 120 days preoperatively for patients with AJCC cT2+ or cN1+, cM0 for gastric carcinoma; or (cT2 and poor differentiation) or cT3+ or cN1+, cM0 for esophageal or gastroesophageal junction carcinoma; age 18-79 GLN15 At least 15 regional lymph nodes are removed and pathologically examined for resected gastric cancer LCT Systemic chemotherapy is administered within 4 months to day preoperatively or day of surgery to 6 months postoperatively, or it is Fall 2014 recommended for surgically resected cases with pathologic, lymph node-positive (pN1) and (pN2) NSCLC BCSRT Radiation therapy is administered within 1 year (365 days) of diagnosis for women under age 70 receiving breast-conserving surgery for breast cancer Breast MAC Combination chemotherapy or chemo-immunotherapy (if HER2 positive), is recommended or administered within 4 months (120 days) of diagnosis for women under 70 with AJCC T1cN0M0, or stage IB-III hormone receptor negative breast cancer Colon ACT Adjuvant chemotherapy is recommended or administered within 4 months (120 days) of diagnosis for patients under the age of 80 with AJCC Stage III (lymph node positive) colon cancer Colon 12 RLN At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer RCRM Circumferential margin is greater than 1 mm from the tumor to the inked, non-serosalized resection margin for rectal resections RECRTCT Preoperative chemo and radiation are administered for clinical AJCC T3N0, T4N0, or Stage III; or postoperative chemo and radiation are administered within 180 days of diagnosis for clinical AJCC T1-2N0 with pathologic AJCC T3N0, T4N0, or Stage III; or treatment is recommended; for patients under the age of 80 receiving resection for rectal cancer
ADDITIONAL CHART TBD
18 - Cancer Institute Annual Report 2022
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Hematology/Oncology Fellowship Established
After many years of planning and anticipation, the Hematology Oncology Fellowship program, approved by the American Council on Graduate Medical Education (ACGME) at The University of Tennessee Graduate School of Medicine (UTGSM), officially launched on July 1, 2022. The Hematology Oncology Fellowship will set the cornerstone for future fellowships in oncology. Timothy J. Panella, MD, is the Fellowship Director for the three- year training program. In July 2022, Dr. James Davidson and Dr. Heidi Worth became the program’s first fellows. The program will recruit two new fellows annually for a maximum of six fellows. The Hematology Oncology Fellowship will provide education and training in both hematology and medical oncology. Fellows will also have opportunities to enhance their research skills during the three-year program. The Cancer Institute (CI), the largest provider of cancer care in the region, offers the broadest spectrum of cancer specialties, treatments, procedures, and services to train tomorrow’s hematologists/medical oncologists. The comprehensive cancer program includes the region’s only Transplant and Cellular Therapy program, as
Pictured Left to Right - Stephen & Brenda Coleman, Eric Berry (former UT football player), Max Coleman with parents Landon & Kristin Coleman, and Dr. Bell.
the educational and research outputs of the UTGSM and the medical center. Dr. Panella stated, “The UTMC Cancer Institute has garnered regional eminence for the specialized care we provide to patients with cancer and blood disorders. We now can teach this knowledge and care to new physicians. What an honor.” Medical Oncology and honors Stephen, who fought his illness with perseverance, courage, determination, and dignity. The fellowship is fully funded through the Stephen Y. Coleman Endowed Fellowship in Medical Oncology. Stephen Y. Coleman lost his courageous battle with brain cancer in 2011. The nonprofit Tailgating Against Cancer (“TAC”) was formed by Stephen’s family to ensure Stephen’s legacy and help support other patients with cancer as well as the families and physicians who work together to improve outcomes. TAC is dedicated to raising funds for the Coleman Endowed Fellowship in
well as state-of-the art diagnostic and therapeutic services, oncology
pharmacists, and certified oncology nurses. Supportive
programs and professionals such as dietitians, social workers, and integrative health services are also available. Physicians selected for the fellowship will work with all members of the cancer team and will also participate in teaching residents and medical students. The fellowship supports the educational missions of both the UTGSM and The University of Tennessee Medical Center while helping address the projected shortage of hematologists and medical oncologists. The American Society of Clinical Oncologists projects a national shortage of more than 2200 oncologists by 2025 while the demand for cancer treatment is expected to grow by 40% as the American population ages. The presence of the Hematology Oncology Fellowship program will serve to both enhance cancer care at the CI and strengthen
20 - Cancer Institute Annual Report 2022
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