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Brookwood Oncology Program Annual Report 2007-2008

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  • 1. Brookwood Oncology Program Annual Report 2007-2008 DATA ENDING DECEMBER 2007
  • 2. Oncology Program Overview | 2007-2008 SYNOPSIS color scheme, furniture and artwork. The hospital’s cancer Brookwood Medical Center’s Oncology Program registry, coordinated by Judy Smith, RHIA, CTR, has continues to serve our community by offering specialized accessioned 1343 cases. This is an increase of 67 cases treatment plans, a variety of support services and amazing over last year, which is reflective of our growing cancer care from our physicians and staff. We are able to provide program. Brookwood’s marketing department unveiled their this quality care due to our team of Oncology Specialists new marketing campaign, involving commercials and encompassing GYN, Surgical, Radiation, Medical, billboards, which facilitated getting Brookwood’s name, Pathologists, Radiologists, as well as nurses, therapists and services and high level of care out into the community. Also, dieticians. All of our specialists are dedicated to performing this year, we have several nurses preparing for the Oncology high quality patient care throughout our facility ensuring that Nursing Certification Exam. This will be a wonderful our patients are always our first priority. accomplishment for each of them as well as our hospital. These are just a few of the exciting things that happened ACCOMPLISHMENTS this year. There is so much to be proud of here at Brookwood. This year we have witnessed a lot of change within our Oncology Program. The Cancer Care Center was EVENTS completely remodeled, increasing our number of exam In September, some of our Brookwood employees rooms from 3 to 5, acquiring new exam tables in each room enjoyed a presentation given by Dr. Mack Barnes, and purchasing the GE 16-slice, large bore CT Simulator. Gynecologic Oncologist, on Ovarian Cancer. His The 7th floor Oncology Unit, under the direction of Cheryl presentation was extremely informative and his ongoing Smith, RN, is enjoying their new Stryker beds. These dedication to our Gyn Oncology Program is greatly specialized beds weigh patients while lying in bed; they also appreciated. Our 3rd annual Mammothon, which took place convert into cardiac chairs from a bed position and deflate in October, was a big success, which is an important automatically for chest compressions. 3Women’s, under the community outreach for our active Breast Cancer Program. direction of Christy Nation, RN, has seen the complete Janet Dees, RN, Community Outreach Coordinator, visited renovation of their new nurses’ station, as well as their our neighborhood schools speaking to our youth on the patient rooms. Designed by Richard Tubbs, the patient dangers of smoking. Janet also continues to grow our rooms now have a relaxed spa like atmosphere with a new genetic testing program and our high-risk breast cancer assessment program.
  • 3. Chairman’s Report THE ONCOLOGY PROGRAM AT BROOKWOOD MEDICAL CENTER provides state of the art treatment to cancer patients in our community. Last year there were 1,211 patients who received a new diagnosis of cancer at this institution, reflecting the continued growth of this program. As in previous years the top five sites were breast, uterine, lung, and colon, with ovarian cancer overtaking prostate cancer for the fifth place this year. The Cancer Registry collects information on these patients and ACKNOWLEDGEMENTS participates in the National Cancer Database as required for all Thank you to Duke Martin for his continued leadership accredited programs by the American College of Surgeons of our Cancer Support Group “Together”. This group has Commission on Cancer. recently changed its name to “Friends Together” and will continue to offer comfort for our patients and family A review of the Brookwood experience in patients with members. Thank you to our volunteers for their support breast cancers less than 2 cm and negative nodes treated with throughout the year with various projects and departmental accelerated partial breast irradiation using MammoSite between tasks. Thank you to our Oncology P.I. Committee members 2003-2007 showed favorable outcomes, with a 3% recurrence who serve diligently throughout the year striving to better rate and good/excellent cosmetic results in 83% of patients. our Oncology program. Our bimonthly meetings, lead by Dr. These figures are consistent with those reported by the Manuel Carcelen, have given us a multidisciplinary Mammosite Registry. approach to reaching our goals. Other leadership roles are As part of the commitment to incorporate new technologies held by William DeVos, MD, who serves as Tumor and provide quality care to our patients in a comfortable Conference Coordinator, Fred Dumas, MD and Sandra environment the Cancer Center has undergone extensive Tincher, MD, who both serve as Physician Advisors and renovation, which has allowed expansion of the facilities and the Jaime Bitran, MD as Physician Liaison. incorporation of a new CT simulator with a respiratory gating LOOKING TO THE FUTURE system, We are currently in the process of building the Cyberknife of Birmingham, which is currently under infrastructure for a CyberKnife, which hopefully will be operational construction, will be located on Brookwood’s campus next in early 2009, and working towards completing upgrades to the to the Cancer Center. Construction began in August and physical plant in the inpatient oncology ward. should be complete by the beginning of 2009. We are Community outreach remains an important goal for the extremely excited that this cutting edge technology will be program, and as in previous years a number of activities to meet available in our region. We are looking forward to being able this need took place, including educational programs for to provide another therapeutic option for some of the most elementary schools, senior citizens groups, and the workplace. difficult to treat tumors. The Cancer Center will also boast a Education on prevention and early detection of colon, breast, and new Varian iX Accelerator in 2009, with Rapid Arc lung cancer are an essential component of the program. capabilities, which will reduce a patient’s treatment time As we prepare for our reaccreditation survey by the American from 10 minutes to 2 minutes. This will really be beneficial to our patients and their comfort level. College of Surgeons Commission on Cancer in 2009, and adjust I look forward to participating in the growth of our to the challenges of an ever changing healthcare market, we Oncology Program. Through our Administrative Leader, Billy remain optimistic that in the coming years Brookwood Medical Connelley, MSHA, and the support of the Senior Team, Center will continue to be a leader in the efforts for prevention , 2009 will be an outstanding year for Oncology. diagnosis and treatment of cancer. Jenni Fisher, BS, CMD, RT(T) Manuel F. Carcelen, MD Manager, Brookwood Cancer Care Center Chairman, Oncology Performance Improvement Committee
  • 4. MammoSite Update The ability to offer APBI using Mammosite to our Brookwood oncology patients began in June 2003. At the time of this update, December 2007, 172 patients have been treated with this technique. BREAST CONSERVATION THERAPY FOR BREAST CANCER The Brookwood data for local control and cosmesis for patients includes radiation to remaining breast tissue after lumpectomy to treated with Mammosite were reviewed to include patients treated decrease local recurrence rates from 35% to 10% or less. This during the 4-year period from June 2003-June 2007 with a minimum usually involves 5 weeks of external radiation to the whole breast of 3 months follow-up. This included 155 patients (range follow-up: (elective treatment of the entire breast for presumed occult disease) 3 months-51 months, mean follow-up: 15 months). Cosmetic followed by a reduced field to the tumor bed for an additional 2 weeks. outcome was scored using Harvard criteria of good/excellent or Advances in radiation technology now allow accelerated fair/poor.1 Any telangiectasia was graded as a fair/poor outcome. partial breast irradiation (APBI) as a potential option for Of the 155 evaluable patients, there were only 7 lost to treatment. This provides radiation to the tumor bed alone follow-up at Brookwood. In addition, 2 patients have tested BRCA delivered internally twice a day over one week, thereby greatly positive and have subsequently undergone bilateral mastectomies. reducing the overall treatment time required to deliver radiation. Our criteria for Mammosite treatment has been: age at least This may allow the benefits of radiation to patients whom 45 years old, tumor size no more than 2cm, negative margins otherwise may not have access to treatment due to barriers and negative lymph nodes. Our actual Mammosite population such as advanced age, transportation, or physical limitations. consists 11pts less than 45 years of age (range: 41-44yrs), DCIS Also, since less tissue is radiated, there is the potential to (43pts), T1N0 (102pts), and T2N0 (10pts). decrease lung and cardiac toxicity and improve cosmesis. There have been 5 recurrences in our Mammosite patients TOP FIVE PRIMARY SITES (2007) | CANCER BY STAGE, TREATMENT & COMPARISON Breast Brookwood = 262 | Alabama = 2,750 | U.S. = 180,510 Lung Brookwood = 116 | Alabama = 3,850 | U.S. = 213,380 STAGE IV 3% UNKNOWN 4% OTHER 2% UNKNOWN–N/A 9% S + C 11% RADIATION 7% STAGE I S + R + C + H 9% S +R+ C STAGE O S + R + C 8% 25% STAGE III 12% 5% 27% S + H 6% STAGE IV SURGERY 38% S +R NONE 22% CHEMO 13% 11% 14% STAGE II 8% STAGE II SURGERY S + CHEMO R + CHEMO 21% 13% 15% 24% STAGE I STAGE III 21% NONE 19% OTHER 7% 30% S + C + H 5% S + R + H 12% Uterine Corpus Brookwood = 135 | Alabama = 460 | U.S. = 39,080 Ovary Brookwood = 69 | Alabama = n/a | U.S. = 22,430 STAGE IV 6% UNKNOWN–N/A OTHER 1% S + CHEMO UNKNOWN 6% S + C 59% S + C + OTHER 7% 12% S + R 2% STAGE IV 6% 3% STAGE III S + R + C STAGE I 15% 1% 25% STAGE II RADIATION 6% 1% STAGE II 5% SURGERY 37% STAGE I SURGERY STAGE III 67% 84% 57% CHEMO 2% Colorectal Brookwood = 90 | Alabama = 2,350 | U.S. = 153,760 STAGE O 2% NONE UNKNOWN 7% 10% STAGE I S + R + C 6% STAGE IV 26% 23% SURGERY STAGE III S + CHEMO 21% 52% STAGE II 28% 21% CHEMO 4%
  • 5. (recurrence rate of 3%). Three of these patients developed PATIENT CHARACTERISTICS metastatic disease without local recurrence, one patient developed OF MAMMOSITE RECURRENCES axillary nodal recurrence, and one patient developed inflammatory Patient 1 2 3 4 5 breast cancer with bone metastasis (see chart right). Our cosmetic outcome has been good/excellent in 128pts Age 67 60 54 53 44 Tumor Size 9 mm 11 mm 22 mm 25 mm DCIS (83%) and fair/poor in 27pts (17%). In the patients with fair/poor LVI No Yes Yes Yes n/a cosmesis, 52% had a skin distance of 7mm or less compared to Grade II III II III HNG only 9% with good/excellent cosmesis. There were 9pts that Tx Date 1/04 11/04 11/04 1/05 4/05 only received Mammosite as a boost due to skin distance and Chemo CMF Refused CA Refused n/a all had good/excellent cosmesis. Grade 2 skin toxicity (moist Recur. Time 19 mo 11 mo 24 mo 12 mo 9 mo desquamation) at 3 week follow up visit strongly predicted for poor Recur. Type DM-lung DM-liver Axilla DM-liver Inflam.Breast- cosmetic outcome. Chemotherapy was delivered in 37% of the Ax,DM Expired 12/05 n/a n/a 3/06 n/a fair/poor cosmesis group compared to 13% of the good/excellent cosmesis group. The time to develop poor cosmetic outcome ranged from 3-36 months with mean of 14 months. with a skin distance of less than 7mm resulting in significantly Recently, 5-year results for Mammosite were reported on 36 poorer cosmesis. The data also showed local recurrence rate of women tumor size limited to 2 cm, node negative, no extensive only 3% (both went on to develop death from metastatic disease) intraductal component and age greater than 44 years old. The data with younger age being significant predictor for recurrence.2,3 showed good to excellent cosmetic outcomes in 83% patients Patterns of failure with Mammosite have also recently been reported on 70 women with 2 year follow up with a 7% local failure rate. It was noted that the recurrences were seen in younger patients, lobular histology, or extensive intraductal FIVE YEAR COMPARISON OF component, and nodal positivity.4 ANALYTIC CASES BY SITE (2003-2007 ) The most recent report from the Mammosite Registry in Site 2003 2004 2005 2006 2007 2007 with 1449 patients showed an overall good/excellent cosmetic outcome of 91%. The local recurrence rate is 2% with Breast 158 178 226 233 262 a median follow-up of 35 months.5 Lung 107 106 127 97 116 Prostate 77 45 73 103 60 In summary, with our current inclusion criteria and treatment Colorectal 75 87 92 100 90 techniques, the patients treated with Mammosite at Brookwood Corpus Uteri 137 122 130 116 133 have had excellent local control rates and cosmetic outcomes Ovary 53 63 81 69 63 very consistent with the national statistics. Total 967 992 1111 1134 1211 Sandra Tincher, MD | Radiation Oncologist Cancer Registry Advisor, Brookwood Cancer Care Center DISTRIBUTION BY AGE & SEX (2007) 1 Harris JR, et al: Red J 5: 257-261, 1979. 2 Benitez PR, et al: Am J Surg 194: 456-462, 2007. I MALE I FEMALE 3 Chao KK, et al: Red J 69: 32-40, 2007. 4 Chen S. et al: Red J 69: 25-31, 2007. 35% 5 Vicini FA, et al: Breast Cancer Symposium 2007, Abstract No. 274 30% 25% 20% SUMMARY OF CANCER INCIDENCE 2007—For 2007, a 15% total of 1, 211 cases of cancer were diagnosed at Brookwood 10% Medical Center. The most common presenting diagnosis is 5% carcinoma of the female breast, comprising a total of 261 cases. 0% This represents an increase of 30 cases over the previous year. 0-29 30-39 40-49 50-59 60-69 70-79 80-89 90+ Age Distribution Nationally, the number of breast cancers has been dropping but this is not yet apparent at Brookwood. The second most common diagnosis we see is carcinoma of the uterus with 133 INCIDENCE BY COUNTY (2003-2007) cases, followed by lung cancer with a total of 116. Colon and rectal cancer represent 90 cases and ovarian cancer has now County 2003 2004 2005 2006 2007 become No. 5 on the list with 63 cases diagnosed last year. Jefferson 452 473 477 539 565 Prostate cancer has become a less common diagnosis at Shelby 159 175 190 200 192 Brookwood due to more patients being treated in the community Talladega 44 43 55 65 71 rather than the hospital setting. When compared to national Montgomery 27 21 24 26 36 statistics, Brookwood treats a slightly higher number of female Chilton 18 23 29 37 31 breast cancers and significantly less lung cancers. We continue Tuscaloosa 17 18 23 24 30 to see an excessive number of gynecologic cancers St. Clair 24 29 36 33 29 Calhoun 23 26 35 18 24 representing patterns of referral to the Women’s Care Center. Other 308 294 343 334 365 Total 1072 1102 1212 1276 1343 R. Fred Dumas, Jr., MD | Radiation Oncologist Medical Director, Brookwood Cancer Care Center
  • 6. ONCOLOGY PERFORMANCE 2007 ONCOLOGY PROGRAM STATISTICS IMPROVEMENT COMMITTEE | 2007-2008 ONCOLOGY CONFERENCES CHAIRMAN PHYSICIAN MEMBERS Total cases presented . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121 Manuel Carcelen, MD R. Fred Dumas, Jr., MD Prospective cases presented . . . . . . . . . . . . . . . . . . . . . . . 111 Pulmonary Medicine Radiation Oncology Percent of Prospective cases . . . . . . . . . . . . . . . . . . . . . . 92% Chairman, Oncology Medical Director, P. I. Committee Brookwood Cancer Cancer conferences. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Care Center Average staff attendance . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 NON-PHYSICIAN Cancer Registry Advisor MEMBERS CANCER REGISTRY Sandra Tincher, MD Ellen Carmichael, CRNP Radiation Oncology Total cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,343 Women's Health Cancer Registry Advisor Analytic cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,211 Clinical Excellence Manager, Non-analytic cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 Quality Improvement Ruth Atkinson, MD Coordinator Hematology/Oncology Cases in registry since reference date. . . . . . . . . . . . . 16,873 Follow-up contacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,754 Billy Connelley, Jr., MSHA, RT(T) Luigi Bertoli, MD Vice President, Operations Hematology/Oncology Percent of Cases Evaluated for Quality Control. . . . . . . 10% Number of Analytic Cases Reviewed for Quality Control . . 121 Janet Dees, RN, MBA Luis Pineda, MD Oncology and Community Hematology/Oncology Outreach Coordinator Mack Barnes, MD Judy Smith, RHIA, CTR Gynecologic Oncology Cancer Registry Coordinator REFERENCES Jamie Bitran, MD Jenni Fisher, BS, CMD, RT(T) General Surgery Clinical Manager, Cancer Liaison, Cancer Facts & Figures 2007 | American Cancer Society Brookwood Cancer Community Outreach Alabama Cancer Facts & Figures 2007 | American Cancer Care Center Leader Society & Alabama Statewide Cancer Registry Karen Litwiniec, PharmD Agnes Cartner, MD AJCC Cancer Staging Manual, 6th Edition | American Joint Manager, Pharmacy Services Radiology Committee on Cancer | Springer-Verlag | New York, NY 2002 Christy Nation, RN J. Christopher Davis, MD International Classification of Diseases for Oncology, 3rd Edition Director, Women’s 3 Otolaryngology World Health Organization | Geneva, Switzerland, 2000 Kristin Pruett, RHIT Bradley Dennis, MD Facility Oncology Registry Data Standards (FORDS) | American Director, Health Information Administration College of Surgeons | Commission on Cancer | Chicago, IL, 2007 Management Chief Medical Officer Collaborative Staging Manual and Coding Instructions | American Cheryl Smith, RN William DeVos, MD Joint Commission on Cancer | U.S. Department of Health and Director, 7 Main Pathology Human Services | Bethesda, MD, 2007 Tumor Conference Coordinator SEER Summary Staging Manual 2000 | Cancer Surveillance, Tracy Flanagan, RHIT, CTR. Cancer Registrar Donald Simmons, MD Epidemiology and End Results Program | National Institute of Pathology Health | National Cancer Institute | Bethesda, MD, 2001 Laura Ann Walley, RN, MSN Multiple Primary and Histology Coding Rules | Field Study Director, Medical Staff/ Bryant Poole, MD Manual | National Cancer Institute | Surveillance Epidemiology Performance Improvement Urology and End Results Program | Bethesda, MD, 2007
  • 7. PRIMARY SITE TABLE | 2007 ANALYTIC CASES M = Male | F = Female Unk. = Unknown Stage | N/A = Benign cases or cases not staged by AJCC SEX AJCC STAGE AT DX PRIMARY SITE TOTAL M F 0 I II III IV UNK N/A Lip 2 2 0 0 0 0 0 0 2 0 Base of Tongue 2 2 0 0 0 0 0 2 0 0 Parotid 3 2 1 0 0 1 1 0 0 1 Esophagus 9 7 2 0 3 4 0 2 0 0 Stomach 16 9 7 0 4 2 3 3 2 2 Small Intestine 4 1 3 0 0 1 1 0 0 2 Colon 64 26 38 1 15 18 13 17 0 0 Rectosigmoid 8 6 2 0 2 1 4 0 1 0 Rectum 18 13 5 1 6 0 2 4 2 3 Liver/Intrahep Bile 5 1 4 0 1 0 1 2 1 0 Gallbladder 2 1 1 0 1 0 0 1 0 0 Other & Unspec Parts of Biliary 2 1 1 0 0 0 0 2 0 0 Pancreas 21 14 7 0 3 2 4 10 1 1 Larynx 8 7 1 0 4 1 2 1 0 0 Bronchus/Lung 116 66 50 0 29 9 24 44 7 3 Thymus 2 1 1 0 0 0 0 0 0 2 Mediastinum, Heart & Pleura 1 1 0 0 0 0 1 0 0 0 Bones, Joints, Art. Cartilage 5 3 2 0 0 0 0 2 3 0 Hematopoietic/Re-ticuloendothelial 42 27 15 0 0 0 0 0 0 42 Skin 19 13 6 2 6 3 1 2 4 1 Retroperitoneum 11 0 11 0 0 0 0 0 0 11 Conn Subq tissue 12 4 8 0 1 2 1 1 7 0 Breast 262 1 261 70 79 64 31 7 10 1 Vulva 45 0 45 27 9 5 0 0 3 1 Vagina 5 0 5 3 0 1 1 0 0 0 Cervix 30 0 30 0 15 3 5 3 4 0 Corpus Uteri 133 0 133 0 90 8 20 8 5 2 Uterus NOS 2 0 2 0 0 0 0 0 0 2 Ovary 63 0 63 0 16 3 36 4 2 2 Other Female 3 0 3 0 1 0 1 0 0 1 Placenta 3 0 3 0 0 0 0 0 0 3 Prostate 60 60 0 0 0 58 0 2 0 0 Testis 4 4 0 0 4 0 0 0 0 0 Kidney 58 34 24 0 43 7 2 6 0 0 Renal Pelvis 6 3 3 1 3 1 1 0 0 0 Ureter 1 1 0 1 0 0 0 0 0 0 Bladder 42 29 13 20 9 4 2 7 0 0 Brain 21 13 8 0 0 0 0 0 0 21 Meninges 28 10 18 0 0 0 0 0 0 28 Other Central Nervous System 7 3 4 0 0 0 0 0 0 7 Thyroid 15 6 9 0 11 1 1 2 0 0 Other Endocrine 5 2 3 0 0 0 0 0 0 5 Lymph Nodes 25 12 13 0 4 6 7 4 4 0 Unknown Primary 21 9 12 0 0 0 0 0 0 21 TOTAL ANALYTIC 1211 394 817 126 359 205 165 136 58 162
  • 8. BROOKWOOD ONCOLOGY SERVICES DIRECTORY Brookwood Medical Center . . . . . . . . . . . . . . . . . . . . . . 205-877-1000 Vice President of Operations . . . . . . . . . . . . . . . . . . . . . 205-877-1893 Brookwood Cancer Care Center . . . . . . . . . . . . . . . . . . 205-877-2273 Manager . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-1094 Scheduling Coordinator . . . . . . . . . . . . . . . . . . . . . 205-877-2228 Oncology Nurse Coordinator . . . . . . . . . . . . . . . . . 205-877-2209 Nurse for Dr. Fred Dumas . . . . . . . . . . . . . . . . . . . . 205-877-2209 Nurse for Dr. Sandra Tincher . . . . . . . . . . . . . . . . . 205-877-2217 Oncology Coordinator. . . . . . . . . . . . . . . . . . . . . . . 205-877-1798 GYN Inpatient Oncology Unit . . . . . . . . . . . . . . . . . . . . . 205-877-5350 Inpatient Oncology Unit . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-1700 Nurse Navigator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-2687 Nutritional Support/Oncology Dietician . . . . . . . . . . . . 205-877-1033 Oncology Chaplain/Counselor . . . . . . . . . . . . . . . . . . . . 205-877-1720 Ostomy Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-2582 Outpatient Medical Oncology. . . . . . . . . . . . . . . . . . . . . 205-877-2256 Physician Referral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-8800 ADDITIONAL SUPPORT SERVICES Alabama Foundation for Oncology . . . . . . . . . . . . . . . . 205-877-2225 American Cancer Society . . . . . . . . . . . . . . . . . . . . . 1-800-ACS-2345 Genetic Testing Breast, Ovarian, Colon and Melanoma Cancer . . 205-877-1798 Camp New Hope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-2224 Camp for children of cancer patients Camp Newsong . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-2224 Camp for children who have had a family member die Cancer Registry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-1383 Hope Lodge. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-888-513-9933 Smoking Cessation . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-QUITNOW Transportation Information . . . . . . . . . . . . . . . . . . . . . . . 205-877-1798 Women's Diagnostic Center . . . . . . . . . . . . . . . . . . . . . . 205-877-5200 Digital mammography, CAD, ultrasound and bone density CANCER SUPPORT GROUPS Bosom Buddies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-ACS-2345 For women with breast cancer Gynecologic Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-975-9523 For women with GYN cancer Look Good Feel Better . . . . . . . . . . . . . . . . . . . . . . . . 1-800-ACS-2345 Free class on makeup application and hair care during cancer treatment Man to Man . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-ACS-2345 For men with prostate cancer Reach to Recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-ACS-2345 Information on exercises for breast surgery recovery, including range of motion exercises for surgical arm STRETCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-824-6666 Exercise class designed especially for women following breast surgery Friends Together . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-1720 For patients with any type cancer and loved ones
  • 9. Brookwood Medical Center 2010 Brookwood Medical Center Drive Birmingham, Alabama 35209 (205) 877-1000 www.bwmc.com Rev. 11/08