Cancer: Our Report to the Community 2012

2012Cancer: Our report to the community

For more than 24 years, King’s Daughters Medical Center has worked with some of the top names in the field of cancer research to advance knowledge and treatment for all patients here in the Tri-State and throughout the world.

CliniCal Trials

Creating the Future of Cancer Treatment

King’s Daughters Oncology Research Department enrolled its first patient in a cancer research trial in June 1988. That research was designed to assess the effectiveness of a certain medication in the treatment of breast cancer, part of the National Surgical Adjuvant Breast and Bowel Project in partnership with the Markey Cancer Center at the University of Kentucky.

Since that time, KDMC has enrolled nearly 500 cancer patients in 58 research studies investigating the effectiveness of new medications, medication combinations, prevention strategies and early detection efforts.

Research protocols are offered through the Kentucky Clinical Trials Network, Southwest Oncology Group, the National Surgical Adjuvant Breast and Bowel Project, and the National Cancer Institute’s Clinical Trials Support Unit.

“Providing access to clinical trials right here in Ashland means that patients who could benefit from this cutting-edge research can access it without the long drives and hassle of going to large urban centers,” said Sherry Davis, R.N., clinical research coordinator.

Over the years, patients at KDMC have helped researchers fine-tune and develop new approaches for the treatment of many types of cancer.

Our Cancer Committee remains dedicated in teaching prevention and healthy lifestyle choices; offering screening and early detection programs; and world-class care throughout our region. In August, our cancer program was re-accredited by the American College of Surgeons for three years with commendation.

Toward this end, it is my pleasure as Chair of the Cancer Committee to present our 2012 Annual Report.

Clockwise from front: Teresa Salyers, physical therapist; Sherri Burton, oncology

nurse manager; Scott Myers, certified tumor registrar; Doretha Pridemore, breast care center supervisor; Amy Shepard, certified

tumor registrar; and Trish Maggard, outpatient IV therapy supervisor

2 | KING’S DAUGHTERS MEDICAL CENTER

Jeff

rey

Lo

pez,

M.D

. C

ance

r Com

mitt

ee C

hair

Radiation Oncologist

CANCER: A REpoRT To THE CoMMUNITy 2012 | 3

A Collaborative Approach

CanCer TreaTmenT

Total Cases - 956

Counties not shown on map:Mason, W.Va. - 5 cases; Cabell, W.Va. - 4 cases; Pike, Ohio - 2 cases; Adams, Ohio - 2 cases; Mingo County, W.Va. - 2 cases; Gallia, Ohio - 2 cases; Putnam, W.Va. - 2 cases. Other counties, one case each: Leslie, Montgomery, Fleming, Jefferson, Knott in Ky.; Prince William in Va.; Pickaway, Wyoming, Marion, Meigs, Miami, Morgan in Ohio; Fayette, Sumner in Tenn.; and one not specified

KDMC Cancer Cases by County at Diagnosis, 2011

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.

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.

Boyd258 cases26.99%

Lawrence123 cases12.87%

Scioto77 cases8.05%

Lewis14 cases1.46%

Greenup124 cases12.97%

Carter106 cases11.09%

Lawrence61 cases6.38%

Elliott8 cases0.84%

Johnson37 cases3.87%

Floyd32 cases3.35%

Martin28 cases2.93%

Pike8 cases0.84%

Wayne11cases1.15%

Rowan7 cases0.73%

Jackson9 cases0.94%

Morgan6 cases0.63%

Magoffin13 cases1.36%

Dav

id G

oeb

el, M

.D.

Onc

olog

y M

edic

al D

irect

or

Oncologist/Hematologist

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 dietitian Amy McFann at (606) 408-1444.

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 follow-up, while maintaining patient confidentiality. Registry data are collected and submitted annually to the Kentucky Cancer Registry and the National Cancer Data Base. The data provide incidence reporting and assists in developing

cancer control efforts. KDMC’s cancer registry currently maintains information on 14,422 patients. For more information, please call (606) 408-1640.

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) 408-1641.

Every institution accredited by the Commission on Cancer must appoint a Cancer Liaison Physician. I am proud to have served in this position for King’s Daughters Medical Center for the past 17 years.

The role of the Cancer Liaison Physician has changed with time, as have the standards as outlined by the Commission on Cancer. The Commission on Cancer is part of the American College of Surgeons and sets the standards hospitals and

medical centers in order to achieve Commission on Cancer accreditation.

These standards originally looked at the ability of each institution to provide the services needed for the treatment of people with cancer, including surgery, radiation therapy and chemotherapy.

Over time, the standards evolved to become more data centered. To achieve accreditation, medical centers must share both survival data and treatment data. Ensuring the accuracy of this data, including accurate staging, is the responsibility of the Cancer Liaison Physician. CoC standards continue to evolve.

The 2012 Standards are more patient centered. The CoC is encouraging programs to use data to improve the quality of care, access to care and prevention of cancer.

A new dimension requires us to

look beyond the medical treatment of people with cancer to programs that support and monitor those who have survived cancer. These new programs look at the quality of life following survival. This is especially important because there are more cancer survivors alive now than at any time in the past.

A new CoC program, called Rapid Quality Reporting System, allows the measurement of quality treatment in real time as each patient is actively undergoing treatment. This system alerts members of our Cancer Committee when a patient may not have received all of the recommended treatments for breast or colorectal cancer.

KDMC enrolled in the RQRS system in 2012; currently only 25 percent of accredited programs in the country are using this quality tool.

Mar

y Le

gen

za, M

.D.

Can

cer L

iais

on P

hysi

cian

CanCer liaison


Palliative care team clockwise from front: Crystal Vance, palliative care coordinator; Barbara Ross, phamacist; Johnny Riley, director of Pastoral Care; and Sam Adams, M.D., hospitalist

General Surgeon

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.

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.

Breast Cancer Support 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.

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.


areas of supporT

Stop for Life At King’s Daughters, we encourage people to stop tobacco use for life through a variety of treatment and support services in the inpatient, outpatient and community setting.

Programs are offered free of charge and are provided by a certified tobacco treatment specialist. On the inpatient side, the tobacco treatment specialist meets with patients whose physicians have ordered nicotine replacement products or Chantix during hospitalization.

The tobacco treatment specialists help each individual develop a quit plan and provide continuing support to each participant through the Stop For Life tobacco free support group, which meets weekly; face-to-face counseling; and telephone support.

For more information, a referral, or to Stop For Life yourself, contact the program by calling (606) 408-6400 or 1-888-377-KDMC (5362).

Tobacco Free Support Group

Skin Cancer Education Every year we provide at least one cancer screening program to decrease the number of patients with late-stage disease. In 2012, skin cancer was selected as an area of focus. Kentucky is one of 13 states with the highest rates of melanoma and is in the Top 7 for mortality. In 2010, there were 41 cases of melanoma diagnosed at KDMC; 56 cases in 2011 and 20 cases as of July 2012.

Skin cancer education and screening included age-specific skin cancer risks, prevention, self assessment, and follow-up advice. Skin cancer education was provided to 3,043 adults and 1,234 adolescents covering five counties in Kentucky and three in Ohio.

During May, Skin Cancer Awareness Month, screenings were provided to 381 patients; 198 were referred for follow-up.


nurse navigaTors

Mary Adams, R.N., MSN Our lung health navigatorassists newly diagnosed patients with lung cancer.

(606) 408-1646 [email protected]

Nurse navigators are patient educators and advocates, care coordinators, healthcare system navigators and community ambassadors on a mission to improve the cancer experience for the patient and their family at a critical time – from diagnosis through treatment. The nurse navigator serves as a bridge to all services available to people with cancer receiving treatment at KDMC.

Early involvement of patient navigators assists patients and their families to access appropriate care and treatment quickly, dramatically improving the chance of a successful outcome. By navigating patients around barriers, patient navigators help ensure cancer patients have individualized options to care.

Have you been diagnosed with cancer and have questions? Please give us a call:

Guiding the Cancer Journey

Lymphedema is a serious side-effect that sometimes affects patients who have been treated for cancer.

It is a swelling of a body part, most often the arms or legs. It also may occur in the face, the abdomen or pelvic region.

It is classified as either primary or secondary. Secondary lymphedema is more common and usually arises following surgery or radiation therapy.

Our team of manual lymphedema therapists treat lymphedema resulting from breast cancer, head/neck/throat cancer, bladder cancer or any type of cancer that involves the removal and/or radiation of lymph nodes.

For information or an appointment, contact (606) 408-4648.

Lymphedema Services

Debbie Alexander, R.N.Our breast health navigator assists newly diagnosed patients with cancer of the breast.


Eva Joseph, R.N., MSN, OCNOur digestive health navigator assists newly diagnosed patients with cancers of the esophagus, stomach, colon and rectum.


King’s Daughters lymphedema specialists from left: Kristie Holmes, physical therapist assistant; and Amy Hay, physical therapist


ouTpaTienT iv TherapyThe Outpatient IV Therapy Center specializes in intravenous (IV) treatments as a convenient alternative to inpatient infusion services. Patients undergoing therapy sit in a comfortable recliner in a treatment bay. They are able to watch TV, listen to music, read or just relax. Services are provided to:

• cancer patients undergoing chemotherapy

• patients with blood disorders

• patients requiring IV antibiotics

• patients requiring frequent medication injections

• patients who require IV treatment, but do not require hospitalization

Services and treatments provided include, but are not limited to chemotherapy, PICC line insertion, central line catheter care, hydration therapy, IV antibiotic therapy, IV immune globulin, intramuscular injections, monoclonal antibodies, subcutaneous injections, therapeutic phlebotomy and transfusion of blood products.

The center is open from 7 a.m. to 7:30 p.m. seven days a week. We work with patients to ensure their IV therapy needs are met with the least disruption to their lives as possible. Families are welcome to accompany patients receiving therapy.

Services are provided by physician order. To contact the center or for more information, please call (606) 408-7076.

Helping individuals, families understand genetic cancer risk

Everyone has some risk of developing cancer. While all of the factors that lead to cancer development are not yet known, medical researchers have been able to group cancers into three broad categories:

Sporadic: These are cancers that develop by chance in about 60 percent of the general population. People with sporadic cancer typically don’t have relatives with the same type of cancer.

Familial: These cancers occur in approximately 30 percent of families. There may be more than one person with the same cancer, but there is not a specific pattern of “passing it down” from parent to child.

Hereditary: Cancer that occurs when an altered gene (mutation) is passed down from parent to child. Approximately 5 to 10 percent of cancer can be linked to heredity.

DNA tests are available to test for specific mutations. Genetic counseling and testing can help individuals determine if they are carriers of these mutations.

Our Hereditary Cancer Program specializes in helping patients/families understand their hereditary cancer risk and steps that can be taken to reduce risk. The program offers both genetic testing and counseling for individuals and families.

For more information, to refer a patient or arrange a free visit, please call (606) 408-1642.

herediTary CanCer

Joseph Hersh, M.D. Geneticist

Dr. Hersh oversees the Hereditary Cancer/Genetic Program at King’s Daughters. He is board certified by the American Board of Medical Genetics and is currently a professor of pediatrics and chief of genetics at the University of Louisville.

Members of the Outpatient IV Therapy Center, clockwise from front: Kristy Rusk, clerk; Dawn Blankenship, nurse; Mary Pat Monnig, nurse; and Leslie Daniel, nurse

Breast cancer is the second common cancer in women, after skin cancer. It is still one of the most curable cancers if found at an early stage. Breast cancer is sometimes found after symptoms appear, but we would prefer to find it prior to any symptoms. This is usually a much earlier stage and more easily cured with less chance of recurrence. This is why getting the recommended screening tests is so important.

Breast Cancer Critique

five-year Case sTudy

A mammogram is an X-ray picture of the breast. Screening mammograms are used to check for breast cancer in women who have no signs or symptoms of the disease. Diagnostic mammograms are used to check for breast cancer after a lump or other sign or symptom of the disease has been found. The National Cancer Institute recommends that women age 40 or older have screening mammograms every one to two years.

Widespread use of screening mammograms has increased the number of breast cancers found before they cause symptoms. With the addition of mobile mammography, KDMC has been reaching out to more and more people in an attempt to increase screening mammograms.

A recent study from London confirms that breast cancer screening saves lives even though it also picks up cases in some women who may not have affected their overall survival. Earlier diagnosis and better treatments have improved the overall survival rate to 77 percent in 2007 from 41 percent in the 1960s.

Women who have regular screening have a 20 percent decreased risk of dying from breast cancer compared to women who do not perform screening.

Stage at Diagnosis Looking at Stage of Diagnosis here at KDMC compared to the state of Kentucky and national data, you can see that our numbers are similar. Most cancers are diagnosed at Stage I or II. We would like to further decrease our Stage III and IV diagnoses and increase Stage 0. Stage 0 is

carcinoma in situ, which is breast cancer diagnosed prior to the cancer cells growing though the wall of the milk ducts. There is usually not a mass or lump associated with this stage.

Breast cancer is usually diagnosed on mammogram, but ultrasound is also a useful tool for diagnosis as well as for guidance in biopsy or surgery. MRI can also be useful, especially in younger women with dense breasts.

The treatment of breast cancer usually involves surgery in combination with radiation and possibly chemotherapy and/or hormone therapy. A multidisciplinary treatment team meets every other week at KDMC to discuss the best treatment options for every patient diagnosed. This has been ongoing for the past 14 years. Women treated at medical centers with this treatment team approach have been found to have higher rates of breast-conserving surgery as well as improved survival.

Mar

y Le

gen

za, M

.D.

Can

cer L

iais

on P

hysi

cian


KDMC and Kentucky State Registry 2011 U.S. statistics: American College of Surgeons Survival NCBD 2009

Breast Cancer Stage at Diagnosis

KDMC - 134 KY - 3,453

US - 211,82326%

26%

25%

12%

9% 9%

40%

40%

38%

7% 5% 5%

14% 18

% 21%

0 I II III IV

40%

30%

20%

10%

0 Per

cent

of

Pat

ient

s

Stages

General Surgeon

First Course of Therapy

Treatments KDMC KY USSurgery/Radiation/Other

28% 17% 18%

Surgery 16% 23% 22%

Surgery/Other 13% 14% 11%Surgery/Chemo/Radiation/Other

13% 7% 9%

Surgery/Radiation 7% 8% 10%Surgery/Chemo/Radiation

6% 5% 8%

No Definitive RX 2% 3% 4%

Other 15% 21% 19%

Total Cases 134 3,453 211,823KDMC and Kentucky State Registry 2011 U.S. statistics: American College of Surgeons Survival NCBD 2009

From left: Bjorn Thorarinsson, M.D., pulmonologist; Katalin Kovacs, M.D., pathologist; Vinay Vermani, M.D., oncologist/hematologist; Mayola Boykin, M.D., radiologist; and Anna Murillo, M.D., oncologist/hematologist

Treatment – First Course Therapy Comparing first course of therapy at KDMC with Kentucky and national data, most women had some combination of therapies. The most common was surgery and radiation. Surgery alone was the most common treatment statewide and nationally. It has been known for many years that surgery, in combination with radiation, and/or chemotherapy and/or hormonal therapy, results in the best survival and lowest recurrence.

Some of the quality measures in breast cancer are the completion of radiation therapy, consideration of chemotherapy and hormone therapy in estrogen-positive breast cancer.

Survival As you can see by the treatment and survival data, the cancer teams at KDMC are giving quality care with better outcomes than national averages. We also treat each person as an individual, making certain they are involved in the decisions of their care.

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

Five-Year Breast Cancer Survival

KDMC584

KY17,083

US683,792

98%97%

90%

94%94%

83%

90%92%

77%

89%91%

72%

88%90%

69%

60 70 80 90 100

5

4

3

2

1

0

Year

s

Percent Alive


In 2012, King’s Daughters Medical Center acquired the new da Vinci SI surgical system, which can be used in the treatment of cancer. The da Vinci SI system allows the physician to perform very precise, delicate maneuvers through extremely small incisions. KDMC has had a da Vinci minimally invasive surgery program since 2007.

With its integrated Firefly technology, the da Vinci system assists the surgeon by showing the difference between cancerous and healthy tissue, as well as the blood supply to tumors. This allows for a more accurate removal of the tumor, potentially lowering the risk of cancer being left behind.

At KDMC, the da Vinci is being used for treatment of cancers of the colon, female reproductive tract and prostate.


da vinCi surgery

Few cancers are as easily preventable as colon cancer and yet colorectal cancer is the second leading cause of cancer death in the U.S. Residents in KDMC’s service area, which includes eight counties in Kentucky and three in Ohio, have higher-than-average incidence of and death rates from this cancer.

In recognition of this, KDMC’s cancer committee selected colorectal cancer as an area of focus for education and screening efforts in 2012, sponsoring 15 events aimed at raising awareness.

The 431 people who participated in these events received information on colorectal cancer incidence, risk factors, symptoms and screening

recommendations. Participants were offered a take-home ColoCARE test kit and assistance in scheduling a screening colonoscopy.

Also in 2012, King’s Daughters began reviewing the records of all patients admitted to determine colon cancer screening status. Those meeting the criteria received educational material and a letter describing screening recommendations.

From Jan. 1, 2012, through Oct. 31, 2012, there were 1,069 patients contacted; 25 percent completed screening colonoscopy.

Saving Lives by Raising Awareness

ColoreCTal CanCer


OnCOLOGy/HEMATOLOGyTri-State Cancer and Blood Specialists Anna Murillo, 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.Garfield Grandison, M.D. Medical Plaza A617 23rd St. | Suite 425Ashland, 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

GEnERAL SuRGERyKing’s Daughters Medical Specialties - Surgery Suite Mary Legenza, M.D.Medical Plaza A617 23rd St. | Suite 13Ashland, Ky. | (606) 325-1151 General Surgeons 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 - Neurosurgery Clark Bernard, M.D.Ondrej Choutka, M.D.Medical Plaza B613 23rd St. | Suite G20Ashland, Ky. | (606) 329-1770

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

DERMATOLOGyCarol Cooper, M.D.1200 Central Ave. | Suite 4 | Ashland, Ky.(606) 324-1483

PuLMOnOLOGyKing’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 RADIOLOGyKing’s Daughters Medical Center RadiologyMayola Boykin, M.D.Erik Fraley, M.D.Candy Howard, M.D., PhDMukesh Kumar Madupur, M.D. Ash Motimaya, 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

InTERvEnTIOnALRADIOLOGyTri-State Vascular SpecialistsWes Lewis, M.D.Pho Nguyen, M.D.613 23rd St. | Suite 140 | Ashland, Ky.(606) 326-1675 uROLOGyKing’s Daughters Medical Specialties - Urology William Boykin, M.D.Sonia Chopra, M.D.Timothy Dixon, M.D.James Krick, D.O.Charles Thorndyke, M.D.336 29th St. | Suite 101Ashland, Ky. | (606) 324-4404

physiCians

Facing page, front row from left: Eric Bronstein, M.D., cardiothoracic surgeon; Stephanie Hutchison, M.D., gynecologist; William Boykin, M.D., urologist; Navita Modi, M.D., ob/gyn; Richard Ford, M.D., ob/gyn; Back row from left: Roderick Tompkins, M.D., general surgeon; Brian Frederick, M.D., ob/gyn; Kelsey James, M.D., ob/gyn; Eric Smith, D.O., general surgeon; and Tony Dotson, D.O., ob/gyn

For more information on any of our programs or sevices for patients and families dealing with cancer, please call (606) 408-1639 or email us at [email protected].

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

Documents

Cancer: Our Report to the Community 2012