2021 MaineHealth Cancer Care Network Outcomes Report
Cancer patients, throughout Maine and the Mt. Washington Valley in New Hampshire, have access to state-of-the-art, coordinated cancer care. The MaineHealth Cancer Care Network is designed to reduce the need for travel whenever possible by connecting cancer patients with cancer experts. Our network is the largest in northern New England, which provides greater access to cancer care specialists who focus on the specific needs of our patients. Plus, we treat the most cancer cases in the region, which is a level of experience that patients and families can trust.
Service Line Message | From Dr. Scot Remick
As the pandemic unfolded in early 2020, the MaineHealth Cancer Care Network stood ready to serve our patients and communities. And, our patients, care teams and communities have remained our top priority.
We thank those care team members who volunteered and others who welcomed new or additional duties beyond their usual roles – including our screeners, greeters and administrative staff assisting with infusion and vaccination sites.
Throughout 2020 and 2021, investing in our people, technology and innovation has enabled the MaineHealth Cancer Care Network to provide cancer care to our patients during these challenging times. Although we experienced decreases in screening, elective surgery and downstream volume the number of patients under active medical oncology or radiation oncology treatment did not decrease. Clinics remained fully operational, newly diagnosed patients were treated following enhanced safety protocols and we implemented telemedicine alternatives and options when appropriate.
Maine cancer patients and their families desire state-of-the-art, patient-centered care. Our singular goal is to ensure that “the right care, in the right location, as close to home as possible” will be provided. Our physicians, many of whom have achieved the highest level of training in their fields, bring together experts in medical oncology, radiation oncology and surgical oncology with peers in radiology, pathology, palliative care, oncology nursing, pharmacy and patient navigation. Our teams evaluate each patient’s case and develop an evidence-based treatment plan. Importantly, we then discuss the recommended plan with the patient and engage in a shared decision-making process that honors their individual values and preferences.
While it has been a year like no other, we welcome the opportunity to partner with you in the care of your patients with cancer, and I hope this report will give you confidence in the quality of care the MaineHealth Cancer Care Network offers.
Scot C. Remick, MD, FACP
Chief of Oncology
MaineHealth Cancer Care Network and Maine Medical Center
Care Rooted in Trust
Margaret McBreairty, a metastatic breast cancer patient from Allagash, Maine, traveled between six and seven hours one way and back for care and treatment at MaineHealth Cancer Care in South Portland. Margaret explained she traveled the distance for a reason -- "the care team knows what they are doing, are so careful and professional, and they all care so much."
"The coronavirus pandemic has changed how we provided care, but the reason why has stayed the same – we are committed to providing patients with the highest quality cancer care," said Christina Stone, a member of Margaret's care team. "When we first started screening at the beginning of the pandemic, Margaret actually got teary when she came in because she was so happy to see how we were handling things."
Margaret is a patient of medical oncologist Roger Inhorn, MD, PhD. She said having a relationship with her care provider that is grounded in trust has made the difference for her. “I know I'm getting better and have made progress.”
Jennifer Roy, RN chats with breast cancer patient Margaret McBreairty
Outcomes Data
Our goal is to provide patients with excellent multidisciplinary, team-based care in an accredited comprehensive cancer program, served seamlessly and as close to home as possible, with outcomes that match or exceed national benchmarks. The network is accredited with the American College of Surgeons (ACoS) Commission on Cancer (CoC) and The National Accreditation program for Breast Centers (NAPBC). Applying for and maintaining CoC and NAPBC approval is a voluntary pledge by a cancer program to ensure quality care for its patients.
The Cancer Registry works collaboratively with the network’s cancer committee to maintain CoC accreditation. The standards required for accreditation cover a broad range of activities including the setting of annual programmatic and quality goals, community-based prevention and screening programs and lifetime follow-up of patients.
Our focus is on improving quality to exceed all national benchmarks in different aspects of cancer care and treatment in the areas that we currently service. We would like to focus our efforts on achieving accreditation with the Quality Oncology Practice Initiative (QOPI), a program run by The American Society of Clinical Oncology (ASCO). It is designed for outpatient oncology practices to measure quality by looking at processes of care while showing commitment to excellence and adherence to evidenced based guidelines.
Evie Taylor MHA, BSN, RN OCN
Senior Director of Quality
MaineHealth Cancer Care Network and Maine Medical Center
Newly Diagnosed Cancer Cases - Analytic Volume
Our network continues to treat the majority of new cancer cases in northern New England. Data used in this report summary represents the MaineHealth Cancer Care Network, and data available as of July 31, 2021.
| 2015 Baseline | 2016 Actual | 2017 Actual | 2018 Actual | 2019 Actual |
| 5,988 | 6,067 | 6,257 | 6,590 | 7,074 |
By Body System
2020 Data: With the pandemic, the number of new diagnosed cancer cases dropped to 5,477, and total number of shared was 667. Top 5 Body System Type by Hospital
Patient Navigation & Screenings
Considering the broader impact of the pandemic, the network team continued to meet the needs of our patients and communities.
Patient Navigation
Screenings
| 2016 | 2017 | 2018 | 2019 | |
| Lung Screening (Baseline Screenings, does not include follow-up scans) |
139 | 192 | 232 | 354 |
| Colorectal Screening (Percent of eligible patients screened) |
64.5% | 73.4% | 76.9% | 78.87% |
| % of Patients Screened | 2019 |
| Patient Education | 84% |
| Screened for Clinical Trials | 58% |
| Screened for Tobacco Cessation | 62% |
Dan Filitis, MD, dermatologist and Mohs surgeon from MaineGeneral, a member of the MaineHealth Cancer Care Network, performs a patient screening.
Cases Discussed in Network Tumor Boards
Tumor boards are multidisciplinary meetings where complex and new patient cases are discussed in significant detail. MaineHealth concentrates on patients with difficult tumors and patients who have previously received treatment and, for a variety of reasons, now need a different treatment plan.
| 2017 | 2018 | 2019 |
| 3,815 | 3,916 | 4,066 |
During 2020, there were 13 tumor board/cancer conferences and 1,541 prospective cases presented.
Maine Medical Center opened two new floors dedicated to oncology atop the hospital’s Coulombe Family Tower, a major milestone in its 2020 $534 million expansion and modernization project. The Susan Donnell Konkel Pavilion for Surgical Oncology and the Marshall L. and Susan Gibson Pavilion for Medical Oncology include 64 single, universal rooms where patients receive state-of-the-art cancer care in a private setting.
View the video on how this addition significantly improves the healing environment for oncology patients.
MMC is an academic health center that serves as the flagship of MaineHealth integrated delivery system in southern and central Maine and eastern New Hampshire. In 2021, U.S. News & World Report named Maine Medical Center a "Best Regional Hospital" for the ninth consecutive year. MMC also was recognized as “high performing” in 13 common procedures and conditions, including colon and lung cancer surgery.
Other hospitals in the network continued to expand and renovate for cancer care, including Southern Maine Health Care’s Sanford Campus, Waldo County General Hospital, Pen Bay Medical Center’s Health Center, LincolnHealth’s Herbert and Roberta Watson Health Center and Western Maine Health’s Stephens Memorial Hospital.
Clinical Trials and NCORP
Maine Health Cancer Care Network was awarded a six-year $5.1 million dollar grant to join the NCI Community Oncology Program (NCORP) in 2019. This grant spans the spectrum of the cancer care continuum from prevention, screening, therapeutic, quality-of-life, to end-of-life and cancer care delivery research.
- In its second year, the transformation NCI award continues to be foundational to our network research efforts that have included competitive supplements to join the high priority NCI Cancer MoonshotSM Biobank Study and an investigator-initiated SARS-CoV-2 antibody period seroprevalence study throughout the cancer care workforce.
- Over the past year, the MaineHealth Cancer Care Network clearly established a trajectory that has enormous potential to raise the bar on patient-centered cancer care in Maine. The NCORP support for oncology research program has been vital in helping MaineHealth create additional infrastructure to support research initiatives throughout the network.
According to Scot Remick, MD, chief of oncology, MaineHealth Cancer Care Network and Maine Medical Center, cancer patients often feel that to get state-of-the-art care and to enroll in clinical trials, they need to travel to a major metropolitan area”. Today our patients have access to advanced care close to home — wherever they live.” The number of clinical trials available to oncology patients in the network is expected to nearly triple over the next five years.
Our clinical trials are research studies that help us find better treatments and ways to prevent cancer and other diseases. Even during the pandemic, the number of total trial accrual grew from 513 in 2019 to 597 in 2020.
Interventional Trial Accrual - 1/1/20 to 12/31/20
| Maine Cancer Genomics Initiative |
National Cancer Institute |
Health Care Workers Sero-Prevalence Accrual |
Maine Children's Cancer Program |
Other Trials |
Total |
| 197 | 164 | 159 | 31 | 46 | 597 |
NCORP Accrual - 8/1/20 to 6/30/21
Year 2
| Trials Accrual | Biospecimen / Special Entries |
| 71 | 140 |
Accrual - patient enrollments to base intervention (Standard or HP), advanced imaging, quality of life in treatment trials, and select other study components
Biospecimen - specimen(s) collection completed
Special Entries - any patient enrollments not belonging to one of the two categories described above
Telehealth Expands
The MMC Cancer Risk and Prevention Clinic transferred its entire practice to telehealth over the past year. Genetic counseling lent itself very well to this model, and we were able to connect with patients in their homes. Connecting by telehealth has also saved patients travel since there are not many genetics clinics in the state of Maine, and some patients had long drives. This increased accessibility was well received by patients and providers alike. We are were able to facilitate genetic testing for patients in their homes too. Several of the genetic testing labs sent saliva collection kits directly to patients in their homes. This expanded options for patients and without the need of a visit to a clinic for an appointment or blood work.
Survivorship Care Plans Support Care
Survivorship begins as soon as a diagnosis of cancer is made. Any person with a history of cancer is considered a cancer survivor from the time of diagnosis through the balance of life, and includes living with, through and beyond a cancer diagnosis. Building upon a successful launch, the network’s grant-funded survivorship care plan program had a successful third year. Additional disease site specific plans were created and implemented, for a total of 15 electronic plans, including melanoma, leukemia/lymphoma and head/neck.
Patient Education Increases
Providing patient with education about their diagnosis, treatment and recovery is an important component of cancer care. The network has a goal of standardizing patient education messages across the network, which helps reduce confusion for patients and supports seamless transitions in care. The standardization of patient education can occur in systems at the practice, region or network level. Regardless of the size of the system, the vision for patient education across the network is to ensure we provide high-quality patient education. Patients benefit when they receive the same messages or instructions from all members of their extended cancer care team.
Shared Decision-making Features Nodule Model
In 2020, the network presented a concept using a 3D lung nodule educational tool to use during shared decision-making discussions with patients undergoing 3D low-dose CT scan lung cancer screening. In this manner, we hope patient distress following an incidental finding of pulmonary nodule(s) can be favorably affected using this model. Theresa Roelke, ANP, invented the 3D lung nodule model and participated in a collaborative research study for screening protocol. Roelke was awarded an Association of Community Cancer Centers’ Innovator Award and an United States patent application was filed.
Breast Care Innovations Support Patients
Maine Medical Center’s Breast Care Center introduced an innovative procedure, called magnetic seed localization, which improves breast cancer patient’s surgical experience. Magnetic seed localization is a technique used to mark a lesion in the breast prior to surgery when the lesion is not palpable. It will be offered at multiple MaineHealth sites in the future. Magseed, a tiny, sterile magnet the size of a grain of rice, can be inserted with the assistance of image guidance prior to surgery. During the surgery, the surgeon uses a magnetic wand to locate the lesion that needs to be removed.
According to Paige Teller, MD, breast surgeon and director of the Breast Care Center in Scarborough, this process will replace the tumor-marking methods of radioactive seed and wire localization which was done institutionally for many years. Magnetic seed localization allows for greater flexibility in scheduling and allows for more consistency in technique regardless of where a patient may have surgery. "The Magseed is more comfortable for the patient than wire localization and offers greater scheduling convenience than prior wire or radioactive seed localization.” said Dr. Teller.
