YOU DESERVE THE BEST IN CANCER CARE.

YOU DESERVE THE BEST IN CANCER CARE. St. Joseph Mercy Port Huron s oncology program has been recognized over and over by the Commission on Cancer (CoC) of the American College of Surgeons as offering the very best in cancer care. It is a recognition of the quality of our comprehensive, multidisciplinary patient care. For 25 years, the Mercy Regional Cancer Center has been dedicated to offering the very best cancer care and is proud to have brought the very best in today s cancer treatment close to home. In 2008, St. Joseph Mercy Port Huron s oncology program received a three-year recertification with nine out of nine commendations. St. Joseph Mercy Hospital s oncology program has been certified with the Commission on Cancer (CoC) of the American College of Surgeons since 1987. One of only two in the state of Michigan, the Mercy Regional Cancer Center is a 2008 Commission on Cancer of the American College of Surgeons Outstanding Achievement Award Winner. SJMPH Cancer Care Experts & members of the Mercy Cancer Committee (1) Medical Oncology -Timothy Cox, MD -Youssef Hanna, MD -Anup Lal, MD Surgeons -Glenn Betrus, MD -Kimberley Clark-Paul, MD -Walid Demashkieh, MD -Krishna Valjee, MD Radiation Oncology -Kanu Dalal, MD Pathology -Homeira McDonald, MD Radiology -Daniel Shogren, DO Oncology Nurse Navigator -Brenda Miller, RN

Mercy Cancer Committee Co-Chairs As chairs of the Mercy Cancer Committee, it is our pleasure to present this annual report for the Mercy Regional Cancer Center. This year s report offers a look at the St. Joseph Mercy Port Huron s Five-Year Cancer Survival data as it relates to the National Cancer Data Base (NCDB), with an extensive focus on prostate cancer. Reflecting outstanding quality and patient care services, this year St. Joseph Mercy s cancer program was honored with the 2008 Outstanding Achievement Award presented by the Commission on Cancer of the American College of Surgeons. One of only two institutions in the state of Michigan to receive the award, it represents the outstanding commitment and clinical dedication of all members of the Mercy Cancer Committee, staff and administration. On behalf of the Mercy Cancer Committee, we hope you will find this report informative and reassuring in highlighting the outstanding cancer care services offered locally through the Mercy Regional Cancer Center. Krishna Valjee, MD Co-Chair, Mercy Cancer Committee Kanu Dalal, MD Co-Chair, Mercy Cancer Committee St. Joseph Mercy Port Huron President & Chief Executive Officer Through our extensive oncology program, St. Joseph Mercy Port Huron continues to be on the leading edge of extraordinary cancer care. Because we are a not-for-profit hospital, we reinvest our profits back into the communities we serve through services such as our expansive cancer center, while providing patients with the utmost compassion and care. I am also very proud to highlight our continued work with the Mercy Cancer Network, elevating our status in providing quality cancer care throughout the state of Michigan. One of Michigan s largest cancer networks, the Mercy Cancer Network links local hospitals and cancer centers throughout the state to provide patients and families access to the most advanced medicine and latest in cancer diagnostics, clinical research trials and therapeutic technology. This has been an outstanding year for the Mercy Regional Cancer Center, dedicated to providing remarkable medicine and remarkable care. Peter Karadjoff St. Joseph Mercy Port Huron President & CEO (2) James J. Snider, MD, Endowment fund (2009) To meet the needs of providing advanced cancer services to the community, the James J. Snider, MD, Endowment Fund was unveiled in spring 2009. This year, funds will be used to purchase a new Stereotactic Breast Biopsy table/ system, providing state of the art technology to local women through the James J. Snider, MD, Mammography Center. remarkable medicine. remarkable care.

Prostate Cancer Five-Year Survival SJMPH 100% NCDB Cases by Year Percentage of Survival 80% 60% 40% 1999 70 20% 2000 53 0 Stage 1 Stage 2 Stage 3 Stage 4 2001 2002 59 70 This graph depicts survival after five years of Stage 1 through Stage 4 prostate cancer diagnosis, Mercy Regional Cancer Center compared to the National Cancer Data Base (NCDB). St. Joseph Mercy s oncology program survival rates for stages 1, 2 and 3 are comparable or higher than NCDB survival rates. Source: Mercy Cancer Registry & the National Cancer Data Base. 2003 57 First Course of Treatment 2004 46 80% 2005 53 70% 60% SJMPH NCDB 2006 52 50% 40% 2007 53 30% 2008 57 20% 10% 10 20 30 40 50 60 70 Surgery Radiation Other/None (3) To learn more: To find out more about the Mercy Regional Cancer Center, visit St. Joseph Mercy online at: mymercy.us; or call toll-free 1-888-MERCYME. This graph depicts first course treatment after prostate cancer diagnosis; 67 percent of SJMPH prostate patients are treated with radiation therapy, compared to 41 percent of NCDB prostate patients. Thirty percent of SJMPH patients are treated with prostatectomy compared to 44 percent of NCDB prostate patients. Source: Mercy Cancer Registry & the National Cancer Data Base.

Prostate Cancer: Age at Diagnosis 50% 45% SJMPH 40% NCDB Percentage of Patients 35% 30% 25% 20% 15% 10% 5% 0 <50 50-59 60-69 70-79 >80 The Mercy Cancer Registry and National data indicate that prostate cancer patients are being diagnosed on a comparative level based on age. The majority of SJMPH patients are diagnosed between 60 and 80 years of age. Source: Mercy Cancer Registry & the National Cancer Data Base. Prostate Cancer: Stage at Diagnosis 100% SJMPH 90% NCDB 80% Percentage of Patients 70% 60% 50% 40% 30% 20% 10% 0 Stage 0 Stage 1 Stage 2 Stage 3 Stage 4 Unknown The Mercy Cancer Registry stage at diagnosis data is comparable to NCDB. The majority of prostate cancer patients are diagnosed at stage 2. (4) Source: Mercy Cancer Registry & the National Cancer Data Base.

Primary Site Table Stage Stage Stage Stage Stage Primary Site Cases A 1 N/A 2 Male Female 0 1 2 3 4 Unk/NA Oral Cavity & Pharynx 9 7 2 6 3 0 0 0 1 0 6 Tongue 1 1 0 0 1 0 0 0 0 0 1 Gum & Other Mouth 3 1 2 2 1 0 0 0 0 0 1 Tonsil 5 5 0 4 1 0 0 0 1 0 4 Digestive System 62 58 4 29 33 2 10 10 15 9 12 Esophagus 3 3 0 2 1 0 0 0 0 2 1 Stomach 5 4 1 3 2 0 0 0 3 0 1 Colon Excluding Rectum 20 20 0 7 13 2 4 4 6 1 3 Rectum & Rectosigmoid 23 21 2 13 10 0 5 4 6 3 3 Anus, Anal Canal & Anorectum 3 3 0 0 3 0 0 2 0 0 1 Liver & Intrahepatic Bile Duct 2 2 0 2 0 0 0 0 0 1 1 Gallbladder 1 1 0 0 1 0 0 0 0 0 1 Pancreas 5 4 1 2 3 0 1 0 0 2 1 Respiratory System 68 64 4 38 30 2 4 3 14 21 20 Larynx 6 5 1 5 1 0 0 0 0 0 5 Lung & Bronchus 62 59 3 33 29 2 4 3 14 21 15 Soft Tissue,, including heart 4 4 0 2 2 0 0 0 1 0 3 Skin,, excluding Basal & Squamous 11 7 4 11 0 3 0 1 0 0 3 Melanoma 9 5 4 9 0 3 0 1 0 0 1 Other Nonepithelial Skin 2 2 0 2 0 0 0 0 0 0 2 Basal & Squamous Skin 2 2 0 2 0 0 0 1 1 0 0 Breast 84 78 6 0 84 18 29 15 10 1 5 Female Genital System 7 6 1 0 7 0 1 3 1 1 0 Cervix Uteri 1 1 0 0 1 0 0 1 0 0 0 Corpus and Uterus, NOS 4 3 1 0 4 0 1 1 1 0 0 Ovary 1 1 0 0 1 0 0 0 0 1 0 Vulva 1 1 0 0 1 0 0 1 0 0 0 Male Genital System 84 59 25 84 0 0 0 36 4 2 17 Prostate 82 57 25 82 0 0 0 36 4 2 15 Testis 2 2 0 2 0 0 0 0 0 0 2 Urinary System 46 42 4 35 11 7 19 11 2 1 2 Urinary Bladder 36 33 3 28 8 5 15 11 1 1 0 Kidney & Renal Pelvis 8 7 1 5 3 1 3 0 1 0 2 Ureter 1 1 0 1 0 1 0 0 0 0 0 Other Urinary Organs 1 1 0 1 0 0 1 0 0 0 0 Brain & other nervous system 1 1 0 0 1 0 0 0 0 0 1 Endocrine System 3 3 0 1 2 0 3 0 0 0 0 Thyroid 3 3 0 1 2 0 3 0 0 0 0 Lymphomas 20 20 0 7 13 0 6 8 2 3 1 Hodgkin Lymphoma 5 5 0 0 5 0 0 5 0 0 0 Non-Hodgkin Lymphoma 15 15 0 7 8 0 6 3 2 3 1 Multiple Myeloma 10 8 2 9 1 0 0 0 0 0 8 Continued...next page (5) St. Joseph Mercy Port Huron Mercy Regional Cancer Center 2601 Electric Avenue Port Huron, MI 48060 1-888-MERCYME mymercy.us

Primary Site Table...cont. Stage Stage Stage Stage Stage Primary Site Cases A 1 N/A 2 Male Female 0 1 2 3 4 Unk/NA Leukemias 3 3 0 2 1 0 0 0 0 0 3 Myeloid & Monocytic Leukemia 2 2 0 2 0 0 0 0 0 0 2 -Other 1 1 0 0 1 0 0 0 0 0 1 Mesothelioma 2 2 0 1 1 0 0 0 0 0 2 Unknown Primary 15 13 2 9 6 0 0 0 0 0 13 Total: 431 377 54 236 195 32 72 88 51 38 96 Primary Site Table This report features the primary cancer sites reported by the Mercy Cancer Registry in which cancer was diagnosed in 2008. This report does not reflect the number of patients currently being treated for cancer through the Mercy Regional Cancer Center, only those patients diagnosed in 2008. A 1 1 Analytic, initially diagnosed and/or treated at St. Joseph Mercy Port Huron. N/A 2 2 Non-analytic cases diagnosed elsewhere, and received subsequent treatment at St. Joseph Mercy Port Huron. N/A 2 Non-analytic cases that are diagnosed with the first course of treatment elsewhere and subsequent treatment at St. Joseph Mercy. Primary Site Table Clinical Comments provided by: Kanu Dalal, MD, Co-Chair, Mercy Regional Cancer Center Cancer Committee Analytic cases increased by eight cases from 2007 (369) to 2008 (377). Breast cancer was the number one cancer diagnosed (78 cases), followed by lung cancer (59 cases) and prostate cancer (57 cases). BREAST CANCER: The number of analytic cases decreased by 17 cases from 2007 (95 cases) to 2008 (78 cases). The majority of the cases were diagnosed at stage 0, 1, or 2. LUNG CANCER: The number of lung cancer cases increased by 10 cases from 2007 (49 cases) to 2008 (59 cases). Unfortunately most of the cases were diagnosed at stage 3 and 4. PROSTATE CANCER: The number of prostate cancer cases decreased by two cases from 2007 (59 cases) to 2008 (57 cases). The majority of prostate cancer cases were diagnosed at stage 2 for both years. COLORECTAL CANCER: The number of colorectal cancer cases increased by 21 cases from 2007 (20 cases) to 2008 (41 cases). Twelve of the colorectal cases were diagnosed at stage 2; four cases at stage 4; and six cases were unknown stage. BLADDER CANCER: The number of bladder cancer cases decreased by seven cases, from 2007 (40) to 2008 (33). The majority of the cases for both years were diagnosed at stage 0, 1 and 2. (6) St. Joseph Mercy Port Huron Mercy Regional Cancer Center 2601 Electric Avenue Port Huron, MI 48060 1-888-MERCYME mymercy.us

Leading Cancer Sites by sex 2008 females Breast Lung Colorectal Lymphomas Bladder males Prostate Lung Colorectal Bladder Lymphomas 2007 females Breast Lung Bladder Colorectal Lymphomas males Prostate Lung Bladder Colorectal Lymphomas Leading Cancer Sites cases by year SITE 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 LUNG 77 83 71 65 58 78 49 76 49 59 COLORECTAL 43 37 35 45 21 21 36 30 20 41 BREAST 110 125 104 100 93 90 80 111 95 78 PROSTATE 84 70 74 71 61 51 52 52 59 57 Source: Mercy Cancer Registry. (7) St. Joseph Mercy Port Huron and its Mercy Regional Cancer Center has been providing cutting edge, extraordinary cancer care to the Blue Water and Thumb communities for more than 25 years.

Mercy Cancer Committee 2008 Accomplishments & Members Following is an outline of the 2008 Mercy Cancer Committee accomplishments and the extensive multidiciplinary team of health care professionals: Awarded the Commission on Cancer of the American College of Surgeons prestigious Outstanding Achievement Award. Sponsored the annual low-cost mammography screening program to the community during the month of October 2008. This service provided women with access to mammography screening as well as increased awareness of breast cancer by distributing informational literature. Hosted Hot Flashes, Hormones & Happy Therapy breast cancer survivor luncheon in October 2008 to enhance understanding of breast cancer and research trials. Served as the premier sponsor of the 17th Annual Mercy Cancer Care Symposium, November 8, 2008, focusing on Cancer Screening, Prevention and Control. Topics included: -Putting Prevention into Practice Cervical Cancer, Colon Cancer -Managing the Disease Colon Cancer -Breast Cancer and Imaging Supported the Mercy Regional Cancer Center s Team in the annual Relay for Life event, sponsored by the American Cancer Society. Held 17 conferences where 94 cancer cases were presented for multidisciplinary discussion of diagnostic testing, pathology results and treatment options for patients. Maintained website link from the St. Joseph Mercy Port Huron s web site to the American Cancer Society web site. Continued distribution of cancer screening brochures, focusing on breast, colon, and prostate cancers as well as an overall and comprehensive screening guide. Distributed outcomes data to the St. Joseph Mercy Medical Staff via Tumor Board conferences and the annual Cancer Care Symposium. Enhanced technology launched Digital Mammography, October 2008. 2008 Members Ronald Balboa, MD (Internal Medicine) Glenn Betrus, MD (Urology) Kimberley Clark-Paul, MD (Surgery) Timothy Cox, MD (Medical Oncology) Kanu Dalal, MD (Radiation Oncology) Walid Demashkieh, MD (Surgery) Yehia Elsafy, MD (Internal Medicine) Youssef Hanna, MD (Medical Onocology) Wasif Hussain, MD (Anesthesiology) Anup Lal, MD (Hematology Oncology) Homeira McDonald, MD (Pathology) Gail McIntyre, MD, JD (VPMA) Kristina Pamukov, DO (Family Practice) Daniel Shogren, DO (Radiology) Krishna Valjee, MD (Surgery) Debbie Amey (American Cancer Society) Shawn Bourne, RN (Oncology Nurse) Lynn Dazer, RN (Home Care) Megan Dziedzic, RD (Dietician) Mary Faulkner, ACSW (Social Work) Mary Galvin (Home Health Care) Brent Gilmore, BS, RT(T) (Radiation Oncology) Janet Hayes, CTR (Cancer Registrar) Stephanie Helton (Outreach/Marketing) Karen Harris, RN (Vice President Nursing) Debbie Hope, RN, (Pain Management) Peter Karadjoff (Administration/CEO) Rita Lappin, RN (Pain Management) Amy Mallory, RT (Women s Center) Cindy Nicholson, RN (Nursing) Karen O Donnell, RN (Clinical Research Nurse) Laura Powell, RN (Oncology Nurse) Karen Quader, RN (Hospice) Christie Sansom, RN (Quality Mgmt Coordinator) Connie Teichow, RN (Radiation Therapy Nurse) (8) SJMPH Clinical Research Trials SJMPH Offers access to the latest clinical research trials through the National Cancer Institute (NCI) designated Community Clinical Oncology Program (CCOP) research basis through Mayo Clinic and M.D. Anderson. To find out more, contact: Karen O Donnell, RN, BSN, OCN; or Sally Jackson, RN, OCN, by calling 810-984-1185; or visit St. Joseph Mercy online at: mymercy.us.

You Deserve the Best in Cancer Care Here s how to be certain you re getting it. The Mercy Regional Cancer Center is a comprehensive cancer program accredited by the Commission on Cancer of the American College of Surgeons and shares a strong affiliation with the American Cancer Society. St. Joseph Mercy Port Huron continually works to update its advanced medical equipment and cancer services. Why should you turn to St. Joseph Mercy Port Huron for cancer prevention, screening and treatment? Because St. Joseph Mercy Hospital has been dedicated for 25 years to providing the most advanced, state of the art cancer treatment from highly-skilled and compassionate professionals. St. Joseph Mercy is the only comprehensive cancer treatment center in the area to offer access to the Michigan Cancer Research Consortium (MCRC), which is part of the Community Clinical Oncology Program (CCOP), providing for access to advanced clinical cancer research trials. It is the only center in the area to offer radiation therapy for the treatment of cancer. It provides access to a multidisciplinary team that works in concert to offer the best cancer treatment options available through individual Tumor Board review. It is the only center in the region to host an Annual Cancer Care Symposium to which health care professionals turn to obtain continuing education credits. The Mercy Regional Cancer Center s comprehensive cancer care services also include: Educational & Screening Activities Diagnostic Capabilities Traditional x-ray Ultrasound 32-slice spiral CT Scans MRI (through Tri-Hospital MRI) PET & PET-CT Scans Treatment Capabilities Board-Certified Physicians on Medical Staff Stereotactic Breast Biopsy Sentinel Node Laboratory Advanced Digital Mammography Dedicated Oncology Unit Certified Oncology Nurses Medical Oncology Tumor Board Conferences Radiation Oncology Radiation Therapy Surgery Prostate Seed Implant (Brachytherapy) Pathology Intensity Modulated Radiation Therapy (IMRT) Radiology Image Guided Radiation Therapy (IGRT) Cancer Treatment Research Protocols; offered in conjunction with Michigan Cancer Research Consortium (MCRC) Community Clinical Oncology Program (CCOP) Institutional Review Board to oversee Research Activities Lymphedema Treatment Cancer & Nutrition Counseling Rehabilitation & Support Capabilities Inpatient and Outpatient Physical Rehabilitation Services Breast Cancer Support Group Spiritual Care Reach to Recovery Look Good...Feel Better Memberships & Affiliations Mercy Cancer Network Saint Joseph Mercy Health System Mercy Cancer Network St. Joseph Mercy Port Huron and its Mercy Regional Cancer Center is a member of the Mercy Cancer Network. Through its expert physicians and support teams, this statewide network provides patients an opportunity to receive care and treatment locally, while providing access to a broad array of technology and specialized treatment options throughout Michigan. (9) To learn more call toll-free 1-888-474-HOPE or visit: mercycancernetwork.com

beating cancer Close to Home You can access the Mercy Regional Cancer Center by letting your physician know you want treatment with the program the Commission on Cancer has named the best cancer care St. Joseph Mercy Port Huron. You can also access the Mercy Regional Cancer Center by scheduling your diagnostic testing through one of the following access points: Traditional x-ray...mercy Express Testing Services at St. Joseph Mercy Hospital or Mercy Health Center, Ft. Gratiot Ultrasound...810-985-1455, phone menu option #2 CT Scan...810-985-1455, phone menu option #2 MRI (through Tri-Hospital MRI)...810-987-2428 PET & PET-CT Scans...Ask your physician to schedule through St. Joseph Mercy Digital Mammography...810-985-1455, phone menu option #2 Available at St. Joseph Mercy Hospital & Mercy Health Center, Ft. Gratiot Laboratory...Mercy Express Testing Services at St. Joseph Mercy Hospital or Mercy Health Center, Fort Gratiot Stereotactic Breast Biopsy... Ask your physician to schedule through St. Joseph Mercy Sentinel Node...Ask your physician to schedule through St. Joseph Mercy Radiation Therapy...Sally Schoenebeck, 810-985-1484 Oncology Nurse Navigator...Brenda Miller, RN, CNOR, 810-985-1871 Clinical Research Trials...Karen O Donnell, RN, OCN, CCRP, Sally Jackson, RN, OCN, 810-984-1185 Lymphedema Therapy...Mary Ann Herrmann, MPT, CLT-LANA Certified Lymphedema Therapist, 810-364-9801 Breast Cancer Support Group...Brenda Miller, RN, 810-985-1871 Reach to Recovery...1-800-227-2345 www.cancer.org (American Cancer Society) Look Good...Feel Better...1-800-227-2345 American Cancer Society Cancer & Nutrition Counseling...Pat Ripari, RD, 810-985-1479 Mercy Home Care...Mary Galvin, 810-966-3060 Sanctuary at Mercy Village...Assisted Living, Diane Cooper, 810-989-7444 Mercy Inpatient Rehabilitation... 810-966-3160 To find out more, visit St. Joseph Mercy online at: mymercy.us. To find a cancer care specialist on staff at St. Joseph Mercy, call toll-free 1-888-MERCYME. You can also find out more information by contacting the American Cancer Society at: cancer.org. The Most Advanced Digital mammography Funded through the Mercy Cancer Network, the Mercy Women s Health Center and its James J. Snider, MD, Mammography Center provides access to the most advanced digital mammography in Port Huron. With images that are transferred electronically as the exam takes place, and access to two centers in both Port Huron and Fort Gratiot Township, local patients can be assured they are receiving the highest quality, compassionate testing available. To learn more, visit St. Joseph Mercy online at: mymercy.us. To make an appointment, call 810-985-1455.

St. Joseph Mercy Port Huron Mercy Regional Cancer Center 2601 Electric Avenue Port Huron, MI 48060 1-888-MERCYME mymercy.us