LOOK FOR THE CROSS. LOOK FOR ST. ANTHONY. 2013 CANCER Annual Report Frank C. Love Cancer Institute i am strong. Incorporating 2012 statistical data
OUR MISSION Our Mission is to become the leading integrated cancer program offering a full spectrum of clinical services, as well as prevention and wellness programs. We are dedicated to caring for our patients with an uncompromising commitment to clinical excellence and customer service. OUR PHILOSOPHY We are committed to fulfilling the mission of St. Anthony Hospital by providing excellence in care and service through the efforts of our highly trained staff and our physicians, and by providing individualized care plans to meet the unique needs of each patient and family. Contents Year in Review 02 Cancer Program Services 04 Melanoma Study 06 2012 Summary 09 Support Groups 13 Patient Education 14 & Community Awareness 2013 CANCER COMMITTEE MEMBERS CHAIRMAN J. Stephen Archer, MD, Urology ACOS CANCER LIAISON Kertrisa McWhite, MD; Breast Surgery PHYSICIAN MEMBERS IM/PULMONARY James Blalock, MD MEDICAL ONCOLOGY L. Michael Bowen, MD Ralph Ganick, MD Thy Nguyen, MD Gary Rahe, MD PATHOLOGY Louis Chambers, MD RADIATION ONCOLOGY Clinton Medbery, MD Marianne Young, MD RADIOLOGY Sylvia Mir, MD SURGERY Timothy Eldridge, MD ALLIED HEALTH MEMBERS ADMINISTRATION Dayla Hall, RN Division Director: Oncology and Neurosciences BREAST CENTER Shannon Wood, BSRT (R)(M)(BS) CANCER REGISTRY Kelly Grabenbauer, CTR FOUNDATION Sherry Rhodes IV THERAPY Karen Ladusau, RN NURSE NAVIGATOR Breast Lori Stewart, RN, BSN, CBPN-IC NURSE NAVIGATOR Lung RESEARCH Vikki Harriet, RN, BSN NURSING Jenni Pinnick, RN, BSN, OCN OP MEDICAL ONCOLOGY Shawn Morrison, Director PALLIATIVE CARE Elain Richardson, RN, BSN, OCN, MBA Chief Nursing Officer PHARMACY Chuck Dreyling, Rph; Director RADIATION ONCOLOGY Chad Crane, BSRT(T) SOCIAL SERVICES Maudie Kuns, MSW
2013 Year in Review In 2013, the St. Anthony Frank C. Love Cancer Institute continued its commitment to provide exceptional quality care for those who entrust us with their care. Several enhancements in services and programs made 2013 an exciting one. Our Patient and Family Advisory Council (PFAC) connects patients and families with members of the healthcare team to provide guidance on ways to improve the patient and family experience. As part of the PFAC process, patients and families are invited to serve on hospital committees to ensure that their point of view, perspective, and experiences are not only heard, but also integrated into the services and quality improvements that are engineered to ensure high quality, customer-centered care. Through sharing of unique perspectives, the members of the PFAC provide input on issues that impact care, ensuring that the next patient or family member s journey is easier. In 2013, the Frank C. Love Cancer Institute was the first in the Oklahoma City metropolitan area to offer a new radio-therapeutic agent. Approved in May 2013 by the Food and Drug Administration (FDA) for the treatment of patients with bone metastasis who have hormone-resistant prostate cancer, Xofigo comes in a series of single injections which is used to destroy the cancer. The new treatment emits low levels of alpha particle radiation, sparing and exposing little surrounding tissue due to small depth of penetration. Treatment with Xofigo has the advantages of enabling a better quality of life, pain relief, prolonged survival and fewer side effects for the appropriate men with castration resistant prostate cancer. On June 2, we hosted our annual National Cancer Survivor s Day Celebration. More than 200 cancer survivors, friends and family members enjoyed great food and entertainment provided by AFFINITY. Several patients spoke and shared their stories of strength, faith and inspiration. Bandana Reds restaurant in Choctaw, Oklahoma, sponsored the 5th annual Bandana Red s Cancer Walk including a live auction, music, food and fun to support the Frank C. Love Cancer Institute s Tree of Life program. The Tree of Life program helps provide assistance to patients and their families experiencing financial hardship during cancer treatment. The Frank C. Love Cancer Institute s dedication to community outreach for education and awareness remained strong in 2013. Our Corporate Mammography Day program continues to be a successful partnership with local businesses to promote a convenient option for staff to have their mammograms. Area businesses may reserve the Breast Center at St. Anthony for a day to exclusively provide services to their employees. Participants are transported from their workplaces to the Breast Center where they are offered complimentary neck/shoulder massages and refreshments for a relaxing experience. The Breast Center hosted 19 Corporate Mammography Day events resulting in 467 mammograms. In August, the Breast Center at St. Anthony achieved the status of Participant in the National Quality Measures for Breast Centers Program (NQMBC). This groundbreaking, one-of-a-kind program developed by the National Consortium of Breast Centers assists breast health care facilities in providing the highest quality of care to their patients. Participation in the program allows the Breast Center to measure and track the quality of care provided to patients and compare performance with other facilities that are measuring quality of performance. The NQMBC Program provides a way to ensure patients that our center not only provides the services they need, but our center is actively monitoring these services to provide each patient with the highest quality of care. In June and September, skin cancer screenings were held on site at Chesapeake Energy Corporation. Our cancer program was pleased to add skin cancer screenings in May and September on site at Devon Energy Corporation as well. A total of 179 participants took advantage of these opportunities. As a result, 46 individuals were referred to a specialist for further evaluation. Dr. Norman Levine, plastic surgeon, spoke in August at the Bi-Monthly Cancer Conference on the diagnosis and treatment of melanoma. More than 60 people attended including several residents from our family practice residency program. According to the Centers for Disease Control, Lung cancer has a higher mortality rate than breast, colon, and prostate cancers combined, making it the deadliest cancer of all. Many of these deaths are preventable by performing low-dose CT screenings on high risk patients in order to detect lung cancer at an early stage. In November, the Lung Cancer Detection and Treatment Center at St. Anthony began offering low-dose CT lung cancer screenings at a low cost of $125 for high-risk patients as defined in the National Lung Cancer Trial and recommended by the American College of Chest Physicians, the American Society of Clinical Oncology, and the National Cancer Institute. Additionally, James Blalock, M.D., Medical Director of the Lung Cancer Detection and Treatment Center, gave a presentation to the St. Anthony residency faculty on the importance of low-dose lung cancer screening for high risk patients. Also in 2013, the Frank C. Love Cancer Institute purchased the Endobronchial Ultrasound (EBUS). EBUS is a relatively new procedure used in the diagnosis of lung cancer, infections, and other diseases causing enlarged lymph nodes in the chest. The technology provides patients with a minimally invasive procedure proven to be highly effective. During the past three decades, the number of cancer survivors has increased dramatically due to improved early detection of first malignancies and the use of effective therapies. Today, there are more than 13 million cancer survivors in the United States. Our cancer program has implemented a Cancer Survivorship Program to address the unique needs of our cancer survivors. The comprehensive program includes resources that address patients physical, psychosocial, and spiritual needs during the survivorship phase of cancer care. Through our Cancer Survivorship Program, we are committed to improve the care of our cancer survivors through advocacy, delivery of high quality patient care, and patient/family/caregiver education and support. We look forward to continuing our mission into 2014: Through our exceptional health care services, we reveal the healing presence of God. We join others throughout the world with hope of finding more improved treatment options to positively impact the patients we serve and their quality of life. 3
Cancer Program Services Frank C. Love Cancer Institute St. Anthony offers comprehensive cancer services in its Frank C. Love Cancer Institute. Located on the ground floor of the hospital s outpatient building, the Cancer Institute houses Medical and Radiation Oncology physician offices and treatment areas, an outpatient laboratory, the Selma Z. Naifeh Patient Education and Resource Center, the Lung Cancer Detection and Treatment Center, the Cancer Registry, and offices for the Nurse Navigator. Breast Center St. Anthony offers a full range of breast health services with same-day test results provided by an onsite radiologist as well as offering osteoporosis screening. Patients may opt for a clinical breast exam (CBE) and/or individual breast self-examination (BSE) instruction during their visit. Services include screening and diagnostic mammography utilizing digital technology, ultrasound, stereotactic guided and ultrasound guided biopsy, ultrasound guided cyst aspiration, needle localization, bone density screening, hereditary breast cancer screening, and other special diagnostic procedures. For the convenience of residents in east and south Oklahoma City, screening digital mammography and bone density services are also offered at St. Anthony Healthplex South and St. Anthony Healthplex East. Cancer Registry The Cancer Registry is an important component of the Cancer Institute. Through the collection and analysis of statistical data, reports on cancer incidence, treatment methods and quality of survival are prepared and submitted to the National Cancer Database (NCDB) and the Oklahoma Central Cancer Registry (OCCR). Essential follow up information and survival data is obtained by following a cancer patient s medical care for his or her lifetime. The Cancer Registry plays an integral part in maintaining the hospital s accreditation through the American College of Surgeons (ACOS), Commission on Cancer (COC). Home Health Care Home Health services are available through SSM Home Care, a St. Anthony affiliated program. This service provides comprehensive care for the cancer patients who have been discharged from the hospital. Home Health professionals work with referring physicians to develop a plan of care that best meets the complex needs of cancer patients and their families. Hospice Hospice services are available on a referral basis to provide physical, emotional and spiritual care for the terminally ill patient and their families through symptom control, pain management and education. St. Anthony partners with Frontier Hospice to provide these services for patients. Inpatient Oncology Located on the hospital s ninth floor, the inpatient unit offers twenty private rooms in a calm, quiet setting. The unit is staffed with experienced oncology nurses who work closely with the staff of the Frank C. Love Cancer Institute to ensure patients and their families have ready access to all available services. One hundred percent of our chemotherapy nurses and 72% of the staff RNs are chemotherapy certified. IV Therapy The Outpatient IV Therapy Department provides comprehensive intravenous therapies to meet a variety of patient needs including blood and blood/product administration, IV fluid/medication administration, ultrasound guided placement of Peripherally Inserted Central Catheters (PICC lines), care of Hickman catheters and implanted venous access devices, comprehensive central line care and patient and family education. Lung Cancer Detection and Treatment Center The Lung Cancer Detection and Treatment Center provides multi-disciplinary care to patients referred with a suspected and/or confirmed diagnosis of lung cancer. Once a cancer is confirmed, the multidisciplinary team meets weekly to develop a coordinated, individualized plan of care for each patient. The team includes a pulmonologist, thoracic surgeon, medical oncologist, radiation oncologist, radiologist, pathologist and nurse navigator working collaboratively to ensure the patient receives the most appropriate advanced treatment available. In 2013, $125 CT Lung Cancer Scans were offered to those at high risk for lung cancer. Medical Oncology Our four board certified medical oncologists are devoted exclusively to treating cancer and hematologic diseases Our approach is comprehensive and cutting edge. Our patients are treated with today s most advanced treatment and therapy options, here in Oklahoma City, where patients have the convenience of receiving most all of their medical and support services under one roof in the comfort of their own community. We collaborate with physicians, nurses, therapists, and other healthcare professionals to ensure continuous support for the patient and their family through the course of treatment and beyond. Our staff of registered nurses is dedicated to excellence in patient care and education. Our oncology nurses are specially trained and licensed in the safe administration of chemotherapy and highly complex drugs. This licensure must be renewed every two years. Many are also Oncology Certified Nurses. To further support our patients starting treatment, a Patient Centered Chemotherapy Education Class is held each week to explain to patients, family members and caregivers important aspects to understand in order to better manage side effects. Multidisciplinary Cancer Conferences Multidisciplinary care is the hallmark of high-quality cancer management. A valuable aspect of the multidisciplinary care provided at St. Anthony is the Cancer Conference. These conferences provide a forum for experts, including physicians, nurses, therapists, and other health professionals involved in the delivery of cancer care to review and discuss individual cancer cases. These collaborative conferences allow key members of the cancer team to make recommendations and develop the best possible treatment plan for each patient. St. Anthony offers a bi-monthly General Cancer/Breast Center Conference and a weekly Lung Cancer Conference. Nurse Navigators Available to patients with any type of cancer and their supporters, Nurse Navigators assist with coordination of care. Nurse Navigators are specially trained Registered Nurses who assist in all aspects of the patient s care experience. They provide education related to diagnosis, treatment and survivorship. When clinical issues arise, Nurse Navigators facilitate seamless care transitions and expedited access to multidisciplinary services. The Frank C. Love Cancer Institute is proud to have two full time Nurse Navigators as part of the cancer team. Lori Stewart, RN, BSN, CBPN-IC is one of only two certified nurse navigators in the state of Oklahoma. Pain Management St. Anthony has expanded its pain management services, offering the latest in advanced interventional pain management services for its oncology patients. Pain Management is located in a designated area on the 3rd floor, conveniently located on a floor directly above the Frank C. Love Cancer Institute. Palliative Care St. Anthony recognizes Palliative Care as a central part of treatment for those facing serious or life-threatening illnesses. As such, we are partnering with American Hospice to further integrate this valuable service as an offering in our cancer program. Pastoral Care Pastoral Care is an integral part of St. Anthony s holistic approach to patient care and is an option offered to all cancer patients. Those who wish to receive pastoral support can rely on the Pastoral Care staff to provide spiritual guidance and emotional support for themselves and their families. Radiation Oncology The Radiation Oncology Department offers a full range of therapeutic services to both inpatient and outpatients. Under the direction of board-certified radiation oncologists, the department is staffed by registered radiation therapists, certified medical dosimetrists, registered nurses and medical physicists. Treatment is delivered using a variety of modalities including the hospital s CyberKnife. The CyberKnife integrates multiple technologies to pinpoint and eliminate tumors using a powerful beam of radiation. The hospital s dual energy linear accelerator offers a full-range of photon and electron energies, 3D computerized treatment planning and CT simulation. St. Anthony also offers brachytherapy, radiation therapy that places radioactive sources at the tumor site. Both low dose and high dose rate (HDR) brachytherapy are available. HDR is currently being used to treat breast, lung, gynecological and prostate cancer. Research The Oncology Research Nurse coordinated patient participation in clinical trials, an important component in the fight against cancer. Participation in the nationwide CyberKnife clinical trial is ongoing. Sleep Rooms Having a loved one in the hospital is stressful for families and friends. St. Anthony offers a number of sleep rooms within the hospital that allows family members to retreat for some needed rest while attending to the needs of their critically ill loved one. 4 5
Melanoma: Staging, Factors and Treatment (2008-2012 Cases) Melanoma was diagnosed in approximately 76,250 cases nationally during 2012. It is less than 5% of all skin cancers but by far the vast majority cause of skin cancer deaths. It is ten times more common in Caucasians than in African Americans. The same is true at St. Anthony Hospital with 97% being white and only 3% of other races. There is increased incidence in women before the age of 40, but after age 40 the incidence rate is twice as high in men. Melanoma rates have been increasing for the past 30 years, and since 2004 incidence rates among whites have been increasing by almost 3% each year in both men and women. An estimated 9180 deaths from melanoma in 2012 were projected. Five to ten year survival rates are 91% and 89%, respectively. For localized melanoma, 84% of the cases, the five year survival rate is 98% but declines to 62% for regional disease and 15% for distant disease. In comparison, St. Anthony rates are similar by state and an overall observed five year survival rate of 69.5%. Treatment for melanoma is primarily surgical. Based on NCCN guidelines, Stage I and II melanomas should be treated with wide excision and with the offering of a sentinel lymph node biopsy. Out of the 80 Stage I cases at St. Anthony from 2008 to 2012 only 1 was treated with an excision biopsy vs wide excision (99% of cases), and only 4 (0.5%) cases did not have lymph node dissection. All 8 Stage II cases received wide excision and 2 (25%) did not have lymph node dissection. These data show we are treating the majority of our stage I and II cases within NCCN guidelines. Twenty-two of our cases were deemed to be Stage III. All were treated with wide excision (100%) and 18 (82%) received complete lymph node dissection. Only 5 (23%) of the cases were noted to have been treated with Interferon. Based on NCCN guidelines, clinical trial vs observation vs Interferon is acceptable for this stage. All four of the Stage IV cases were treated with wide excision and one with Interferon. Based on these findings, St. Anthony is treating melanomas within NCCN guidelines. Prognostic factors such as Breslow s depth, regression, mitotic index are now a standard part of the pathology report and included in registry data. Louis Chambers, MD 5 Year 4 Year 3 Year 2 Year 1 Year References: NCCN treatment guidelines for Melanoma; ACS Cancer Facts and Figures 2012 100 6 80 MELANOMA BY RACE 97% Caucasian 2% Native American 1% Black MELANOMA BY SEX 65% Male 35% Female 60% Stage I 17% Stage III 7% Unknown 7% Stage 0 6% Stage II 3% Stage IV 5-year Survival Rates All Stages 20% 40% 60% 80% 100% 5-YEAR SURVIVAL RATES ALL STAGES MELANOMA BY SITE 32% Head/Neck 26% Trunk 22% Upper Extremety 18% Lower Extremety 2% NOS MELANOMA BY STAGE
Summary of 2012 Cancer Cases INCIDENCE For the calendar year 2012, there were 705 new cancer cases diagnosed and/or initially treated at St. Anthony Hospital. The most common malignancy diagnosed at St. Anthony for the year was again, lung cancer with 20.9 percent. This was followed closely by breast cancer with 15.6 percent. Colorectal cancer ranked third with 9 percent and melanoma was fourth with 6.5 percent (see Figure 2). Comparison of St. Anthony data with National and State statistics is provided in Figure 1. SEX An analysis of cancer cases by sex showed that males accounted for 51.1 percent of all cases, while females accounted for 48.9 percent. Distribution of cases by site and sex is shown in Figures 3 and 4. AGE Cancer incidence increases with age and it was noted that only 14.6 percent were under the age of 50. Forty-eight percent of the new cancer cases were between the ages of 50 and 69. Thirty-eight percent were initially diagnosed over the age of 70. STAGE AT DIAGNOSIS A comparison of new cancer cases for 2012 was completed utilizing the AJCC (American Joint Committee on Cancer) TNM staging system. See below: AJCC STAGING Stage 0 4% Stage I 24% Stage II 17% Stage III 17% Stage IV 24% Stage 88 11% (no TNM staging system available) Unknown 3% TREATMENT Surgery alone was the first course of therapy in 32 percent of the 2012 cancer cases. Thirty percent of the cases were treated with radiation therapy either alone or in combination with surgery and/or chemotherapy/hormonal therapy. Chemotherapy was also utilized in 34 percent of the cases either alone or in combination with surgery and/or radiation therapy and/or hormonal therapy. Fourteen percent of the cases were either unsuitable candidates for any of the above modalities or had no record in the registry of having received treatment. 9
Figure 1: Distribution of Cancer Cases by National, State and St. Anthony Hospital (2012 Data) Melanoma St. Anthony Hospital Oklahoma National Colorectal Breast Lung 0 5% 10% 15% 20% 25% Figure 2: ten Most Common Malignancies (Calendar Year 2012) Primary Site Number of Cases Percent of Total Cases Lung & Bronchus 147 20.9 Female Breast 110 15.6 Colorectal 63 9.0 Melanoma 46 6.5 Thyroid 44 6.2 Prostate 38 5.4 Kidney/RP 35 5.0 Lymphoma 32 4.5 Leukemia 19 2.7 Urinary Bladder 17 2.4 Distribution of Cancer by Site & Sex (Calendar Year 2012) Figure 3: Male Distribution Top 5 Sites Number of Cases Percent of Total Cases LUNG 81 22.5 PROSTATE 38 10.6 MELANOMA 34 9.4 COLORECTAL 30 8.3 LYMPHOMA 26 7.2 ALL OTHER SITES 151 42.0 TOTAL 360 100% Figure 4: Female Distribution Top 5 Sites Number of Cases Percent of Total Cases LUNG 110 31.9 PROSTATE 66 19.1 MELANOMA 33 9.6 COLORECTAL 33 9.6 LYMPHOMA 12 3.5 ALL OTHER SITES 91 26.3 TOTAL 345 100% 10
Support Groups St. Anthony Cancer Support Group is a gathering of adult cancer patients and their supporters. Facilitators present information, provide comfort, teach coping skills, help reduce anxiety, and provide a place for people to share common concerns and emotional support. People who take part in support groups believe that they can live healthier, happier lives if they spend time relating to others. They believe that when relatives and friends lend support, it is easier for people to deal with their health and social problems. Some claim that the bonds formed between members of support groups help them feel stronger. They further claim that sharing feelings and experiences within support groups can reduce stress, fear, and anxiety and help to promote healing. Evidence suggests that support groups can improve quality of life for people with cancer. Patients may select from three different support groups: two on the St. Anthony main campus and one at Eastern Oklahoma County Technology Center Vo-Tech in Choctaw. St. Anthony Chemo Class is an educational class for adult cancer patients who are beginning chemotherapy as part of their treatment plan. During the hour-long class, a Registered Nurse who is highly specialized in Oncology and chemotherapy, informs patients and caregivers about the characteristics of chemotherapy, including side effects, risks, and their impact on quality of life. By attending Chemo Class, patients are more relaxed before their first chemotherapy treatment and more informed about their cancer treatment plan. Expressive Arts is an interactive group for adult cancer patients and their supporters. Participants learn to manage physical and emotional problems by using creative activities to express emotions. It provides a way for people to come to terms with emotional conflicts, increase self-awareness, and express unspoken and often unconscious concerns about their illness and their lives. Participants are given the tools they need to produce paintings, drawings, crafts, and many other types of artwork. St. Anthony staff facilitators help participants express themselves through their creations. They are encouraged to talk about their emotions and concerns as they relate to their art. Expressive Arts provides benefit to cancer patients and supporters in ways such as reducing anxiety levels, improving recovery times, improving communication and social function, pain control, and improved quality of life. Look Good Feel Better is a hands-on workshop that teaches beauty techniques to adult female cancer patients to help them manage the appearance-related side effects of cancer treatment. Look Good Feel Better is open to all women with any type of cancer who are currently undergoing chemotherapy, radiation, or other forms of cancer treatment. St. Anthony sponsors one of 14,500 group workshops nationwide in more than 3,000 locations.thousands of volunteer beauty professionals support Look Good Feel Better. All are trained and certified by the Personal Care Products Council Foundation, the American Cancer Society, and the Professional Beauty Association National Cosmetology Association at local, statewide, and national workshops. St. Anthony staff and other volunteer professionals also give their time to the program. 13
Patient Education and Community Awareness The Selma Z. Naifeh Patient Education and Resource Center offers a wide array of cancer education materials including books, video and audio tapes, and access to the internet. The Resource Center is open to patients, family members and others in the community. Lung Cancer Screening is available by self-referral for high-risk persons. A spiral CT scan of the lungs is performed at a modest fee and all results are read by board-certified radiologists. Breast Cancer Screening is available by self-referral through the Breast Center at St. Anthony. Our digital mammograms offer immediate results, and if a problem is detected, a biopsy can be performed the same day. Skin Cancer Screenings are held annually. Here, physicians give patients a total body visual screening for skin abnormalities. Race for the Cure is an annual walk/run that benefits the Central Oklahoma Chapter of the Susan G. Komen Breast Cancer Foundation. St. Anthony sponsored a team at the 2012 event. Cancer Survivor s Day is an annual event held each June that provides an opportunity for family and friends to honor those surviving a cancer diagnosis. This year s event was attended by more that 200 people with a survivor recognition program concluding the event. Genetic Screening for Breast Cancer is available to all women through the Breast Center at St. Anthony. If testing is indicated, a referral for further evaluation and/or testing can be made to a genetic specialist. Band Together with Bandana Red s Against Cancer is an annual event held each October to raise money and awareness for cancer patients in Oklahoma. A portion of the proceeds are directly contributed to the Frank C. Love Cancer Institute at St. Anthony. A two and four-mile walk is the cornerstone of the event, followed by family activities, live music, and food. This year s event was attended by over 100 people. 14
ST. Anthony Frank C. Love Cancer Institute Physicians and Staff Ralph Ganick, MD, Medical Oncology Internal Medicine, Oncology, Hematology University Hospital, Boston, MA Marianne Young, MD, Radiation Oncology Radiology, Radiation Oncology National Cancer Institute, Bethesda, MD J. Stephen Archer, MD, Urology Oncology Urology M.D. Anderson Cancer Hospital Thy Nguyen, MD, Medical Oncology Internal Medicine University of Oklahoma Dayla Hall, RN, SAN Director: Oncology and Neurosciences Breast Center Kertrisa McWhite, MD, Surgical Breast Oncology Surgery Susan G. Komen/University of Texas Southwestern Gary Rahe, MD, Medical Oncology Internal Medicine University of Oklahoma Lori Stewart, RN, BSN, CBPN-IC Patient Navigator, Breast Inpatient Oncology Unit, 9th Floor James Blalock, MD, Pulmonary Disease Internal Medicine, Pulmonary Disease University of Oklahoma Clinton Medbery, MD, Radiation Oncology Internal Medicine, Medical Oncology, Radiation Oncology National Cancer Institute, Bethesda, MD Vikki Harriet, RN, BSN Patient Navigator, Lung Medical Oncology L. Michael Bowen, MD, Medical Oncology Internal Medicine, Oncology, Hematology Astrid Morrison, MD, Radiation Oncology Radiation Oncology Maudie Kuns, LCSW Coordinator, Patient Education and Resources LSU Medical Center and University of Oklahoma Radiation Oncology 17
Frank C. Love Cancer Institute 1000 N. Lee Oklahoma City OK 73102 405.272.8490 saintsok.com A Member of SSM Health Care 2014 SSM Health Care. All rights reserved. SAH-14-11811 3/14