Cancer Community Report 2011

Cancer: A report to the community

King’s Daughters cancer program has been continuously accredited by the American College of Surgeons Commission on Cancer since 1994. Our program is designated a comprehensive community cancer program by the commission and received its most recent approval, with commendation, in 2009.

KING’S DAUGHTERS:

Commission on Cancer Approved with Commendation

Commission approval requires successful completion of a rigorous, on-site evaluation process and performance review. Only 25 percent of hospitals in the U.S. have earned such approval. The approval with commendation represents additional levels of compliance with these rigorous standards. Commendation level was awarded in seven of nine key areas, including leadership; quality improvement; clinical services; cancer data management; and community outreach. For more information about any aspect of our program, email us at [email protected].

Access to cutting-edge treatment and research King’s Daughters has been participating in cancer research for more than 20 years. We participate in an array of research trials, which allows us to offer patients cutting-edge treatment options right here in their own communities.

Local, State and National Cancer Cases by Type, 2010

KDMC and Kentucky State Registry 2010 U.S. statistics are from American Cancer Society Facts & Figures 2010

KDMC KY US

Male

Prostate 23% 16% 28%

Lung 22% 21% 15%

Colorectal 11% 12% 9%

Bladder 7% 6% 7%

Melanoma 4% 5% 5%

FemaleBreast 26% 30% 28%

Lung 20% 16% 14%

Colorectal 14% 10% 10%

Thyroid 10% 4% 5%

Melanoma 5% 4% 4%

The field of cancer research is ever-expanding, and King’s Daughters works alongside some of the top names in cancer research to advance knowledge and treatment for all patients with cancer. Our Oncology Clinical Research focuses on and takes pride in being able to offer both treatment and prevention options to patients through research trials.

Our collaboration with other institutions, such as the University of Kentucky Medical Center and the Kentucky Clinical Trials Network; and sponsors, including the National Surgical Adjuvant Breast and Bowel Project, Southwest

Oncology Group, and the National Cancer Institute’s Clinical Trials

Support Unit, brings the most recent advances in cancer treatment to you, close to home.

Clockwise from front: Shamsa Haroon, M.D., pathologist; Jeffrey Lopez, M.D., radiation oncologist; Khalid Shalaby, M.D., general/surgical oncologist; and Vinay Vermani, M.D., oncologist/hematologist2 | KING’S DAUGHTERS MEDICAL CENTER

CANCER: A REPORT TO THE COMMUNITY 2011 | 3

A Collaborative Approach

CANCER TREATMENT:

Boyd262 cases28.5%

Lawrence130 cases

14.2%

Scioto54 cases

5.9%

Lewis12 cases

1.3%

Greenup115 cases

12.5%

Carter94 cases10.2%

Lawrence56 cases

6.1%

Elliott11 cases

1.2%

Johnson42 cases

4.6%

Floyd27 cases

2.9%

Martin28 cases

3.1%

Pike11 cases

1.2%

Wayne22 cases

2.4%

Rowan3 cases0.3%

Jackson6 cases0.7%

Morgan3 cases0.3%

Magoffin13 cases

1.4%

Total Cases - 918

Counties not shown on map:Cabell County, W.Va. - 3 cases; Gallia, Ohio - 3 cases; Mingo County, W.Va. - 3 cases; Mason, Ky. - 2 cases; Mason, W.Va. - 2 cases; Logan, W.Va. - 2 cases. Other counties, one case each; Menifee, Wolfe, Fleming, Harrison, Knott in Ky.; Elkhart, Ind.; Adams, Meigs, Pike, in Ohio; Hawkins, Tenn.; and Kanawha and Putnam, W.Va.; 3 cases out of region.

KDMC Cancer Cases by County at Diagnosis, 2010

Perhaps more than any other medical discipline, the treatment of cancer requires the expertise of many. Medical oncologists, radiation oncologists, surgeons, family physicians, many specialized physicians, nurses, physical therapists, researchers, dietitians, social workers, pastoral care … the team may incorporate some, or all, of these professionals, working together to provide the most effective, evidence-based treatment for patients with cancer. Surgical OncologyFor many types of cancer, surgery is the first-line treatment of choice, either alone or in combination with other therapies. Our surgical oncology program offers advanced treatment options for many cancers, including those that affect the lungs, chest wall, skin, breast, and digestive systems. Our surgical team is made up of board-certified surgeons, an experienced operating room staff, clinical pathologists and more.

Oncology Specialty Unit The Oncology Specialty Unit at King’s Daughters offers personalized and highly skilled nursing care for patients who require hospitalization. The 25-bed unit provides private rooms and a family kitchen. Consistently rated by our customers as providing very good care, the Oncology Specialty Unit strives to give meaningful and specialized care to all cancer patients and families.

Outpatient Infusion King’s Daughters Outpatient Infusion Center offers convenience to patients needing IV therapy. The center is open 12 hours daily, seven days a week. Highly skilled nurses provide treatment for patients. A social worker helps with obtaining social and financial assistance. The infusion team can be reached by calling (606) 408-7076.

Cardio-Oncology ProgramNew this year is a cardiology program designed to follow up on patients who have received specific types of chemotherapy and/or radiation. The cardiology team reviews personal treatment plans and evaluates further recommendations to safely assist patients through recovery and survivorship. The Cardio-Oncology Clinic can be reached by calling the Center for Heart Health at (606) 408-6000.

Nutrition SupportIn cancer care, dietitians play a role at every stage. Dietitians are involved with primary prevention, cancer treatment, secondary prevention, and palliative/end-of-life care. Often a dietitian assists patients toward a speedier recovery. Dietitians can consult patients in the hospital or on an outpatient basis. For additional information, please call our dietitians Amy McFann at (606) 408-5021 or Heather Jenkins at (606) 408-6795.

Distress ManagementKDMC’s Distress Management program was created this year to assist patients who may be experiencing a wide range of feelings and emotions. Patients are screened for distress and re-evaluated with any change in condition or treatment plan. Referrals can be made at any time by a healthcare provider or by contacting the Center for Healthy Living at (606) 408-5193.

Hereditary Cancer Program Approximately 5 to 10 percent of cancers can be linked to heredity. Some individuals may be referred to explore their personal risk for cancer. The program is affiliated with the University of Louisville and Joseph Hersh, M.D., Chief of Genetics. For additional information, please call (606) 408-6213.

Palliative CareKing’s Daughters palliative care team works to improve the quality of life for patients and families. The palliative care team offers an individualized approach and can be reached by calling Crystal Vance at (606) 408-3836 or email to [email protected].

The cancer liaison physician’s role is to enhance communication between the Commission on Cancer and the physician champions serving in commission-accredited cancer programs.

The liaison is in a leader role within the cancer program and is responsible for evaluating, interpreting and reporting the program’s performance using the National Cancer Data Base to the cancer committee. This helps improve the quality of care; to enhance cancer prevention initiatives; and improve access to care.

Other responsibilities include reporting on commission activities, initiatives and priorities to the program’s cancer committee; serving as a liaison to the American Cancer Society; and participating in the commission accreditation survey.

The liaison physician plays a vital role in providing the leadership and direction to monitor, maintain, and improve quality in your cancer program. I have served in this voluntary role at KDMC since 1995.

This past year, I was named the state chair for Kentucky Commission on Cancer. This is a three-year appointment elected by the Kentucky Council of the American College of Surgeons. In this role, I represent Kentucky at national meetings of the commission. As state chair, I communicate regularly with cancer liaison physicians throughout the state.

State chairs are the connections between the national commission and local cancer liaison physicians. We help hospitals use accreditation standards to improve quality of cancer care; encourage hospitals without accreditation to become accredited; and provide education through the media and conferences.

General Surgeon Mary Legenza, M.D.

CANCER LIAISON

Physician

4 | KING’S DAUGHTERS MEDICAL CENTER

Palliative care team from left: Courtney Bowman, social worker; Johnny Riley, director of Pastoral Care; and Crystal Vance, palliative care coordinator

In times of crisis, it’s good to have someone to turn to who has traveled the same road. King’s Daughters support groups for patients (and families) dealing with a cancer diagnosis can help. For more information on our support groups, email us at [email protected].

LOOK GOOD, FEEL BETTERCo-sponsored with the American Cancer Society, this monthly support group provides tips and techniques for those undergoing cancer treatment to help them overcome appearance-related side effects of cancer treatment. This program is offered monthly. For more information, contact Doretha Pridemore at (606) 408-7067.

REACH TO RECOVERYCo-sponsored with the American Cancer Society, this active group of breast cancer survivors provides personal and informative support individually to patients as needed. This program is offered monthly.

ROAD TO RECOVERYCo-sponsored with the American Cancer Society, trained volunteers drive patients to and from physician appointments and therapies. This service is available in several surrounding counties.

Tobacco Cessation ProgramKDMC offers a successful tobacco cessation program that has helped hundreds throughout our community break their addictions to tobacco. Participants meet one hour each week for 24 weeks. The classes are free; participants are responsible for purchasing tobacco cessation products. For more information contact (606) 408-6400.

Cancer Registry

King’s Daughters Cancer Registry identifies patients diagnosed and treated for cancer at the medical center. Cancer registrars collect a complete history of patient activity from diagnosis through treatment, with lifetime followup, while maintaining patient confidentiality.

Registry data are collected and submitted annually to the Kentucky Cancer Registry and the National Cancer Data Base. This provides incidence reporting and assists in developing cancer control efforts. KDMC’s cancer registry currently maintains information on 12,940 patients.

King’s Daughters Cancer Registry is staffed by three certified tumor registrars.


Eva Joseph, R.N., MSN, OCN, our digestive health navigator, assists newly diagnosed patients with cancers of the esophagus, stomach, colon and rectum. Contact her at (606) 408-3741 or [email protected].

AREAS OF SUPPORT

Patient Navigators

Debbie Alexander, R.N., our breast health navigator, assists newly diagnosed patients with cancer of the breast. Contact her by calling (606) 408-4067 or emailing [email protected].

Mary Adams, R.N., MSN, our lung health navigator, assists newly diagnosed patients with lung cancer. To contact her, call (606) 408-6110 or email [email protected].

Women facing a cancer diagnosis have special concerns. Will my hair fall out? Where can I find a wig that looks natural? Will my insurance cover it? Where can I find breast forms and mastectomy bras? Is there someone qualified to help fit me?

In August 2011, King’s Daughters launched its Women’s Boutique, a specialty shop located inside the Breast Care Center at KDMC’s Center for Advanced Imaging. The boutique offers special swimwear, bras, breast forms, turbans and scarves, as well as other merchandise, such as jewelry, candles and cancer awareness items.

Dianna Maynard, a certified mastectomy fitter with 20

years of experience, staffs the boutique. For more information or to arrange a fit appointment, please call (606) 408-2019.

Women’s Boutique


Clockwise from front: Cristina Alencar, M.D., oncologist/hematologist; Mary Legenza, M.D., general surgeon; Robert Penkava, M.D., radiologist; Katalin Kovacs, M.D., pathologist; and David Goebel, M.D., oncologist/hematologist

BREAST CARE CENTER

Accreditation Breast cancer continues to be an important health issue for women throughout our region. At King’s Daughters, we recognize the impact of a breast cancer diagnosis on women and their families, and do everything we can to promote prevention, early detection, rapid diagnosis, treatment and positive outcomes.

In recognition of our efforts, King’s Daughters was awarded accreditation from the National Accreditation Program for Breast Centers, a program of the American College of Surgeons Cancer Program. KDMC was the first in our region to achieve this designation.

The NAPBC is a consortium of national, professional organizations dedicated to improving the quality of care and monitoring outcomes of the breast diseases.

In earning the accreditation, King’s Daughters met all 44 program standards and components identified by the NAPBC, while ensuring the most efficient and contemporary care available for patients with diseases of the breast.

Radiologist Robert Penkava, M.D., and surgeon Mary Legenza, M.D., are co-medical directors of King’s Daughters Breast Care Center.

We take Breast Cancer seriously

What is a breast navigator? The breast health navigator guides patients with breast abnormalities through additional testing and physician appointments.

Our breast health navigator coordinates care throughout treatment. She can assess the physical, psychological and social needs of the patient. The results are enhanced patient outcomes, increased satisfaction, and reduced cost of care. This may involve different individuals at each point of care.

Debbie Alexander serves as King’s Daughters breast health navigator. She can be reached by calling (606) 408-4067 or emailing [email protected].

Lymphedema Women who have been treated for breast cancer may be at risk for arm, breast, and chest swelling called lymphedema (limf-uh-dee-muh). Most women who have had breast cancer will not

develop this side effect, but some will. The risk of lymphedema is higher for women who have surgery and radiation therapy to treat breast cancer.

King’s Daughters provides lymphedema care through two certified lymphedema specialists. Contact our breast health navigator for assistance or email us at [email protected].

Breast Cancer Support Group Women battling breast cancer have unique questions and concerns. This support group provides a community of women who have faced – or are facing – some of these concerns. By sharing together, each member is strengthened. The group meets quarterly. For more information, contact Doretha Pridemore at (606) 408-7067.


If breast cancer could be defeated by sheer strength of numbers, the battle would have ended Saturday, Oct. 1, 2011. Nearly 600 people joined forces to participate in the Susan G. Komen for the Cure Lexington I Am the Cure Walk in Ashland’s Central Park.

The event was a huge success – exceeding the $80,000 fundraising goal.In all, 564 walkers representing 51 teams registered.

Komen for the Cure focuses on helping uninsured and underinsured women get the treatment, screening and education they need to battle breast cancer. Seventy-five percent of the funds raised stay in eastern and central Kentucky and will be used to fund these services. The remaining 25 percent helps fund national research on breast cancer.

Survivors, walkers show strength

KOMEN FOR THE CURE

Doretha PridemoreBreast Care Center supervisor and breast cancer survivor

Prostate cancer is the second leading cause of cancer deaths among American men. The American Cancer Society estimated more than 240,000 new cases of prostate cancer would be diagnosed in 2011, and 33,000 men would die of the disease. Approximately one in six American men will be diagnosed with prostate cancer in his lifetime.

The goal of KDMC’s Cancer Committee aligns with those of the American Cancer Society: By 2015, we want at least 90 percent of men in our service area to follow age-appropriate detection guidelines for prostate cancer.

Risk Factors It is not completely understood what causes prostate cancer, but researchers have found several factors that may impact risk:

Prostate Cancer Treatment

FIVE-YEAR CASE STUDY

Radiation Oncologist Jeffrey Lopez, M.D.


King’s Daughters Medical Specialties - Urology physicians, clockwise from front: William Boykin, M.D.; Timothy Dixon, M.D.; Charles Thorndyke, M.D.; and James Krick, D.O.

Signs & Symptoms Early prostate cancer usually causes no symptoms. It is most often found by a PSA (Prostate-Specific Antigen) test and/or manual exam. Some advanced prostate cancers can slow or weaken the urinary stream or increase frequency of

urination. In some cases, kidney blockage can occur. Patients with advanced prostate cancer may have blood in the urine.

• Age: This is the single strongest risk factor for prostate cancer. The disease is very rare before the age of 40, but the risk rises rapidly after age 50. Two-thirds of cases are found in men age 65 and older.

• Race/ethnicity: Prostate cancer occurs more often in African-American men than others. Prostate cancer occurs less often in Asian-American and Hispanic/Latino men.

• Family History: Prostate cancer can run in families, which suggests that there may be an inherited or genetic factor. Having a father or brother with prostate cancer more than doubles a man’s

risk of developing this disease.

• Diet: The exact role of diet is not clear. Men who eat a lot of red meat or high-fat dairy products appear to have a slightly higher chance of getting prostate cancer. Some studies suggest that diets high in lycopene (e.g., tomatoes, especially those cooked in oil) may reduce the risk.

• Exercise: Some studies have found higher levels of physical activity, particularly in older men, may lower the risk of advanced prostate cancer.

• Smoking: A recent study linked smoking to a small increase in the risk of death from prostate cancer.


Urologist William Boykin, M.D. and the da Vinci® system

Prostate Cancer by Age Distribution

97%97%97%

1

2

3

4

Year

s

0 80 85 90 95 100

Percent Alive

5

96%95%95%

96%93%

92%

95%92%

89%

94%91%

86%

3%3%4%

40-50

50-60

60-70

70-80

Age

0 10 20 30 40 50

Percent Alive

80-90

21%22%

24%

40%42%

41%

26%25%25%

10%7%

6%

90+

20%

40%

60%

80%

Perc

ent

of P

atie

nts

0 I II III IV Unknown

Stages

100%

89%

82%

79%

2%8% 8% 8% 6% 5%

1% 4% 6%

1%1%1%

KDMC - 101

KY - 2,607

US - 134,723

Early DetectionMortality rates for prostate cancer have been declining, and according to some experts, this may suggest early detection using the PSA test or manual exams may be beneficial.

However, the results of three large clinical trials designed to determine the efficacy of PSA testing were not in agreement. Two European studies found a lower risk of death from prostate cancer among men receiving PSA screening while a U.S. study did not. Further analysis of these studies is under way. Most experts agree the current evidence is insufficient to recommend for or against routine testing for early prostate cancer detection.

In 2010, the American Cancer Society guidelines for the first time provided detailed recommendations to clinicians on core factors related to prostate cancer screening and treatment. The guidelines recommend information should be shared with men and that asymptomatic men who have at least a 10-year life expectancy, and have an opportunity to make an informed decision, should consider having prostate screening. Men at average risk should receive this information beginning at age 50. Men at higher risk should receive this information at age 40 to 45, depending on individual risk profiles.

The Five-Year KDMC Experience Each year, the Cancer Committee of King’s Daughters provides an in-depth analysis of a specific type of cancer. This year, we are looking at the question: “How does prostate cancer treatment at King’s Daughters compare to that of Kentucky and the U.S.?”

Age at DiagnosisApproximately 40 percent of men diagnosed with prostate cancer at King’s Daughters were age 60 to 69. Twenty-five percent were diagnosed in their 70s.

Unless otherwise noted, data represent KDMC Registry 2010; Kentucky State Registry 2009; and U.S. statistics

are from American Cancer Society Facts & Figures 2008.


Stage at Diagnosis The stage of the cancer at diagnosis is important to treatment planning. King’s Daughters follows the National Comprehensive Cancer Network Guidelines (NCCN) in treatment planning. NCCN guidelines are considered the “gold standard” for treatment of patients with cancer.

In reviewing stages of prostate cancer, the earlier the diagnosis, the greater the chance for improved outcomes. King’s Daughters is above average in the early diagnosis of prostate cancer. Approximately 80 percent of patients at KDMC were diagnosed at Stage II.

King’s Daughters physicians are vigilant about promoting and encouraging prostate screening, and our community outreach efforts, which provide free screenings each September, also play an important role.

Treatment – First Course Therapy The treatment of prostate cancer depends upon the stage at diagnosis, the aggressiveness of the cancer, and the preferences of the patient. Treatment for prostate cancer may include surgery, radiation therapy, chemotherapy, hormone therapy, or a combination of these. At King’s Daughters, 30 percent of patients received surgery as the first course of treatment; 18 percent underwent radiation therapy as the first course of treatment; 14 percent received a combination of radiation and hormone therapy.

Survival King’s Daughters survival rates exceed those of Kentucky and the U.S. This is attributed to a higher rate of early diagnosis at KDMC. The five-year survival rate at KDMC was 94 percent; for Kentucky residents, the five-year survival was 91 percent. Nationally, the five-year survival rate was 86 percent.

Prostate Cancer Stage at Diagnosis

97%97%97%

1

2

3

4

Year

s

0 80 85 90 95 100

Percent Alive

5

96%95%95%

96%93%

92%

95%92%

89%

94%91%

86%

3%3%4%

40-50

50-60

60-70

70-80

Age

0 10 20 30 40 50

Percent Alive

80-90

21%22%

24%

40%42%

41%

26%25%25%

10%7%

6%

90+

20%

40%

60%

80%

Perc

ent

of P

atie

nts


Stages

100%

89%

82%

79%

2%8% 8% 8% 6% 5%

1% 4% 6%

1%1%1%

KDMC - 101 KY - 2,596

US - 134,774

Five-Year Prostate Survival

KDMC and Kentucky State Registry 2001-2005U.S. statistics are from the American College of Surgeons NCBD 1998-2002

97%97%97%

1

2

3

4

Year

s

0 80 85 90 95 100

Percent Alive

5

96%95%95%

96%93%

92%

95%92%

89%

94%91%

86%

3%3%4%

40-50

50-60

60-70

70-80

Age

0 10 20 30 40 50

Percent Alive

80-90

21%22%

24%

40%42%

41%

26%25%25%

10%7%

6%

90+

20%

40%

60%

80%

Perc

ent

of P

atie

nts


Stages

100%

89%

82%

79%

2%8% 8% 8% 6% 5%

1% 4% 6%

1%1%1%

KDMC - 232

US - 477,362

KY - 13,278

First Course of Therapy

Treatments KDMC KY US

Surgery 30% 42% 49%

Radiation 18% 15% 20%

Hormone 14% 5% 4%

Radiation & Hormone 14% 10% 12%

Surgery & Other 4% 2% 1%

Chemotherapy & Radiation

1% 1% 0%

Other N/A N/A 5%

No Treatment 19% 25% 9%

Total Cases 101 2,596 134,774


ONCOLOGY/HEMATOLOGYTri-State Cancer and Blood Specialists Cristina Alencar, M.D. Vinay Vermani, M.D.2301 Lexington Ave. | Suite 135Ashland, Ky. | (606) 324-3333

Tri-State Hematology/ Oncology Mary Edgecomb, D.O.David Goebel, M.D.Medical Plaza A617 23rd St. | Suite 19Ashland, Ky. | (606) 325-2221

RADIATION ONCOLOGYTri-State Regional Cancer CenterTerry Justice, M.D.Jeffrey Lopez, M.D.706 23rd St. | Ashland, Ky.(606) 329-0060

CARDIOTHORACIC SURGERYCardiothoracic Surgeons of Kentucky Eric Bronstein, M.D.Robert Fried, M.D.J.C. MacHannaford, M.D.Medical Plaza B613 23rd St. | Suite 210Ashland, Ky. | (606) 326-9847

GASTROENTEROLOGYAshland Gastroenterology Rajkumar Warrier, M.D.300 St. Christopher DriveSuite 200 | Ashland, Ky.(606) 836-9644 King’s Daughters Medical Specialties - Gastroenterology Morris Beebe, M.D. Arthur Gaing, M.D. 1200 Central Ave. | Suite 3Ashland, Ky. | (606) 327-1760

Tri-State Digestive Disease Associates Cheryl Bascom, M.D.Michael Canty, M.D. Medical Plaza A617 23rd St. | Suite 11Ashland, Ky. | (606) 324-3188

Digestive Health & Nutrition Center of Ashland Alla Grigorian, M.D.Houssam E. Mardini, M.D.Medical Plaza B617 23rd St. | Suite 120Ashland, Ky. | (606) 329-1049

GENERAL SURGERYKing’s Daughters Medical Specialties - Surgery Suite Mariano Faresi, M.D. (colorectal)Mary Legenza, M.D.Khalid Shalaby, M.D.Medical Plaza A617 23rd St. | Suite 13Ashland, Ky. | (606) 325-1151 Eric Smith, D.O.Roderick Tompkins, M.D.Timothy Wheeler, M.D.Medical Plaza B613 23rd St. | Suite 440Ashland, Ky. | (606) 329-2888

NEUROSURGERYKing’s Daughters Medical Specialties - Neurosurgical Specialists Clark Bernard, M.D.Ondrej Choutka, M.D.Medical Plaza B613 23rd St. | Suite G20Ashland, Ky. | (606) 329-1770

Tri-State Christian Neurosurgical AssociatesJames S. Powell, M.D.Medical Plaza A | Suite 15 617 23rd St. | Ashland, Ky.(606) 324-7737

OTOLARYNGOLOGYEar, Nose & Throat Associates of AshlandJon Brinkman, D.O.William Van Beneden, D.O.2550 Carter Ave. | Ashland, Ky.(606) 325-3588

King’s Daughters Medical Specialties - Otolaryngology Gregory Baker, M.D. Medical Plaza B613 23rd St. | Suite 420Ashland, Ky. | (606) 324-2600

PATHOLOGYProfessional Pathology Hayma Al-Ghawi, M.D.Linda Eskew, M.D.Shamsa Haroon, M.D.Malisha Johnson, D.O.Katalin Kovacs, M.D.Diane Marie Pierson, D.O.2201 Lexington Ave. | Ashland, Ky. (606) 408-4022

PLASTIC & RECONSTRUCTIVE SURGERYKing’s Daughters Medical Specialties - Plastic & Reconstructive Surgery W. Bryan Rogers III, M.D.Medical Plaza B | 613 23rd St.Suite 420 | Ashland, Ky. | (606) 324-2600

Kassan Aesthetic & Anti-Aging Centre Martin A. Kassan, M.D.945 29th St. | Ashland, Ky.(606) 326-9888

Bellefonte Cosmetic and Reconstructive Surgery Phillip Lackey, M.D.2001 Winchester Ave. | Ashland, Ky.(606) 325-0753

PULMONOLOGYAshland Medical Group Mohamad Abul-Khoudoud, M.D.Diego Maldonado, M.D.Mahmoud Moammar, M.D.1061 Kenwood DriveRussell, Ky. | (606) 833-5864

King’s Daughters Medical Specialties - Pulmonary & Critical CareScott Nelson, M.D.Gregory Stark, M.D.Bjorn Thorarinsson, M.DMedical Plaza B613 23rd St. | Suite G30Ashland, Ky. | (606) 329-1185 RADIOLOGYTri-State RadiologyMayola Boykin, M.D.Erik Fraley, M.D.Candy Howard, M.D., PhDWes Lewis, M.D.Mukesh Kumar Madupur, M.D. Ash Motimaya, M.D.Pho Nguyen, M.D.Robert Penkava, M.D.Stella Powell, M.D.Alvin Schwarz, M.D.Amina Tariq, M.D.Charl Van Wyk, M.D.2201 Lexington Ave. | Ashland, Ky.(606) 408-4627 UROLOGYKing’s Daughters Medical Specialties - Urology William Boykin, M.D.Timothy Dixon, M.D.James Krick, D.O.Charles Thorndyke, M.D.336 29th St. | Suite 101Ashland, Ky. | (606) 324-4404

PHYSICIANS

For more information on any of our programs or sevices for patients and families dealing with cancer, please email us at [email protected].

(606) 408-4000 | kdmc.com/cancer

Documents

Cancer Community Report 2011