Cancer Center Annual Report 2006 - St. Mary Medical Center

2 0 0 6 | A N N U A L R E P O R T
St. Mary Regional Cancer Center

CANCER COMMITTEE
Physician Members
Michael P. Mann,
DO, FACOI
Chairman,
Medical Oncology
Andrea Barrio, MD
Breast Surgery
Brett L. Moses, MD
Otolaryngology
Robert E. Reilly, DO
Director, Cancer Research
Medical Oncology
Peter Sinaiko, MD
Urology
Randy Booth
Thoracic Oncology
Coordinator
Joseph Camp, RPh
Pharmacy
Julie Cannan-Siegle
Nutrition
Stephanie Loeper
Social Work
Ed Maher
VP/CFO
Theresa McGrath
American Cancer Society
Liaison
Richard C. Berg, Jr.
General Surgery
Guillermo J. Bernal, MD
Physical Medicine/Rehab
Robert M. Cardinale, MD
Radiation Oncology
Benjamin S. Chack, DO
Cancer Liaison Physician
Otorhinolaryngology–Surgery
Brian Chon, MD
Radiation Oncology
Joseph Conroy, MD
VP, Medical Affairs
Zenon Gibas, MD
Pathology
Michael Guttman, MD
Medical Oncology
Howard Hammer, DO
Surgery, Otolaryngology
Wayne M. Marley, MD
Dermatology
Diana Stripp, MD
Radiation Oncology
Paul Weiser, MD
Radiology
Other Members
Barbara Adons, BSN, RN
Community Health Services
Christine Armetta,
BS, MBA, CCRA
Oncology Research
Coordinator
Margaret Benner
Process Improvement
Coordinator
Robin Bitting
Radiology Services
Jackie Boekel, RT
Radiology & Imaging
Services Director
Mary F. Connolly, PA-C
Oncology Research
Coordinator
Stefanie Crawford, LSW
Supportive/Palliative Care
Patrick Donohue
Marketing &
Communications
Mary Doyle, RN
Pain Management Program
Merle Eskowitz
Holistic Health Program
Christine Eustace
Pain Management Program
Vicki Farrell, RN
Radiation Therapy – Nurse
Education
Jane Fridman, RHIT
Tumor Registrar
Sandra Holly, RN, BSN
Nurse Manager Oncology
Sr. Marie Barbara McNamara
Spiritual Care
Suzanne Monte
Administrative Director
Radiology/Oncology
Mital Patel, RHIA, CTR
Lead Tumor Registrar
Charles Quinn, RTT
Cancer Center Manager
Christina Rybak, MS
Family Risk Evaluation
Program Coordinator
Judy Stevens, RN, BSN, OCN
Palliative Care/Support
Service
Debbie Thompson-Carry,
RN, BSN, OCN
Oncology Nursing Education
William Trojan, MBA
Oncology Program Director

TABLE OF CONTENTS
I. Chairman’s Report.........................................................................................................................................5
II. Cancer Support Services...............................................................................................................................8
Clinical Research Program .....................................................................................................................8
Family Risk Evaluation Program ...........................................................................................................8
Diagnostic Radiology .............................................................................................................................9
St. Mary Breast Center..........................................................................................................................10
Radiation Oncology.............................................................................................................................10
Inpatient Oncology Unit......................................................................................................................11
Oncology Nursing Education ..............................................................................................................12
Outpatient Infusion Center .................................................................................................................12
Pharmacy.............................................................................................................................................12
Nutritional Counseling ........................................................................................................................13
Pain Management Center.....................................................................................................................13
Supportive / Palliative Care..................................................................................................................14
Healing Ministries................................................................................................................................14
Holistic Services...................................................................................................................................15
Social Services .....................................................................................................................................15
Spiritual Care ......................................................................................................................................16
III. Cancer Program Activities...........................................................................................................................17
IV. Department of Pathology and Laboratory Medicine.....................................................................................18
V. Cancer Registry Report................................................................................................................................19
VI. Multidisciplinary Cancer Conferences.........................................................................................................21
VII. Statistical Reports........................................................................................................................................22
A. Risk of Falls for the Aging Cancer Population.........................................................................................22
B. Utilizing Partial Breast Irradiation...........................................................................................................24
VIII. Glossary of Terms......................................................................................................................................26
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To raise awareness about the importance of routine mammogram screening, the St. Mary Breast Center hosted a town hall meeting
on October 26. CN8’s Lynn Doyle moderated the panel, and the session aired on the Comcast Network. Pictured (from L-R) are:
Dr. William Mechanic, Radiologist; Dr. Robert Reilly, Medical Director of Cancer Research; Lynn Doyle; Dr. Brian Chon, Radiation
Oncologist; and breast cancer patient Nancy Broadbent.
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ON E
CHAIRMAN’S REPORT
This past year has been one of significant progress here at St. Mary. Since its inception,
St. Mary has made caring for cancer patients a priority. Now, as a result of the committed efforts
of the Board of Directors and the unfaltering energy of a dedicated staff, we are able to
proudly offer the community the most comprehensive, state-of-the-art cancer management
in a beautiful and convenient setting close to home.
Today’s sophisticated patients are aware of cutting-edge treatments and have a
right to expect no less from their cancer center. That is why St. Mary has made it
a priority to invest in the most advanced, up-to-date diagnostic and treatment
technologies. By the end of 2007, we will have introduced several outstanding
cancer care services. Because of this commitment, we are recognized as one of
the most progressive cancer care providers in the Southeastern Pennsylvania
region. In this way, at St. Mary we are able to offer an uncompromised level of
care in a location that is convenient for the families in Bucks County and the
surrounding region.
St. Mary continues its Community Hospital Comprehensive Cancer Program with
Michael P. Mann, DO, FACOI
accreditation from the American College of Surgeons (ACoS) Commission on
Cancer. Mindful of ACoS guidelines for quality care, our experts practice every
day with the St. Mary emphasis on compassion — which is at the core of our values.
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PREVENTION
We always have made strong efforts toward cancer prevention,
and as knowledge increases, we continue to adopt measures that
protect our community. Therefore, St. Mary Medical Center has a
smoke-free policy throughout its campus. Moving forward, we will
have the breakthrough lung CAD technology that can digitally
spot cancers too small to be seen through conventional x-ray. All
patients ages 30 years or older who need to receive a chest x-ray
for any reason automatically will be screened in this fashion to
detect lung cancer as early as possible. Additionally, St. Mary
continues its practice of offering free cancer-screening days to
the community to educate and to help detect cancers of the
skin, breast, and prostate.
DIAGNOSIS
In addition to our already excellent diagnostic capabilities, the year
has seen the continued utilization and significant success of digital
mammography. St. Mary anticipates the acquisition of PET/CT
imaging, which will give clinicians more complete insight into the
presence and extent of malignant disease. The accuracy and
precision of this modality are unparalleled, and it will be at St. Mary
in early 2007.
TREATMENT
St. Mary offers patients true multidisciplinary care. Oncologic
surgeons at St. Mary are experienced in treating neurologic,
pulmonary, gastrointestinal, genitourinary, gynecologic, orthopedic,
and cutaneous malignancies. Our medical oncologic staff is
expanding and is prepared to intervene in virtually all adult patient
malignancies.
Our Radiation Oncology Department, staffed by experienced
physicians, is now working with the most sophisticated and up-todate
equipment in the region. We offer the patient radiation therapy
(XRT) with conventional external beam therapy through our new
linear accelerator. We have the capability of intensity modulated
radiation therapy (IMRT), as well as conformational XRT that
centers radiation specifically on the tumor, sparing nearby tissues.
In addition to the more conventional radioactive seed form of
brachytherapy, high-dose rate (HDR) brachytherapy will be an
available treatment option. Also in early 2007, St. Mary will acquire
additional advanced cancer treatment planning and therapeutic
technologies such as Wide Bore CT with respiratory gating and
HI-ART TomoTherapy, which will give us enhanced image-guided
radiation therapy (IGRT) capabilities.
HEALING
At St. Mary, treatment extends to the whole person — body, mind,
and spirit. Nutritional counseling, meditation, exercise, bodywork
therapies such as massage and Reiki therapy, and spiritual
counseling are important elements of treatment. In continuation
of their invaluable work at St. Mary, the Social Services and
Spiritual Care Departments provide services such as hospice
intervention, pain management, and spiritual counseling, as well
as bereavement care.
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St. Mary recognizes the need to support not only the cancer patient
but also his or her family in coping with the life changes brought on
by fighting cancer. Therefore, family members are embraced and
incorporated into the healing process.
other primary research hubs, we are expanding opportunities for
research into cancer treatment breakthroughs.
PHYSICAL FACILITIES
EDUCATION
Continuing education opportunities for cancer specialists at St.
Mary continue to grow. The regularly scheduled tumor conference
has been enhanced by an expanded format. Audiovisual equipment
has been updated, allowing for more active participation by
conference attendees. On a regular basis, experts from many
cancer disciplines present timely topics at these conferences.
A dedicated breast cancer conference meets regularly, as does
our newest thoracic cancer conference.
In June, the St. Mary Continuing Medical Education Committee
hosted its first-ever oncology CME program. During the halfday
event, participants learned about the latest innovations,
discoveries, and changes in the diagnosis, care, and management
of lung, colorectal, prostate, and breast cancers. New trends
in radiation oncology and neuro-oncologic surgery also were
covered. Dr. Michael Mann moderated the program, and session
speakers included Robert Reilly, DO; Robert Cardinale, MD; Carlin
McLaughlin, DO; Evan Alley, MD, PhD; and Nirav Shah, MD.
CLINICAL RESEARCH
St. Mary also plans to renovate its Inpatient Oncology Unit.
This attractive unit will offer patients private, homelike suites in
the setting of excellent clinical care. The rooms are designed
with comfort and safety, as well as efficiency, in mind. With
computerization, medical records and imaging will be readily
available to the clinician and nursing staff. Private rooms will
minimize disruptions during recovery, while ample common
space, a meeting room, and a tea room will allow for needed
social activity and family interactions. This eagerly awaited new
addition to St. Mary will serve our community for years to come.
Plans are also in the works to build a Healing Garden specifically
for patients of the Cancer Center.
The St. Mary Regional Cancer Center community can be very proud
of our past year’s accomplishments, but as always, the St. Mary
cancer team will not rest without trying to do even more.
I look to our future with pride and hope.
Michael P. Mann, DO, FACOI
Chairman
Clinical research at St. Mary continues with renewed vigor. In
partnership with pharmaceutical companies as well as university and
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TWO
CANCER SUPPORT SERVICES
St. Mary Medical Center takes a team approach to our cancer patients’ diagnosis, treatment,
and holistic healing. Our comprehensive cancer program is recognized not only for its size and
level of sophistication, but also for its commitment to supporting our patients and their families
in every aspect of care—physical, emotional, spiritual, and psychological.
CLINICAL RESEARCH PROGRAM
Residents of Bucks County and surrounding areas stand to benefit from cuttingedge
medical research available at St. Mary Medical Center. The Medical Center
works in cooperation with prominent research organizations such as the Eastern
Cooperative Oncology Group (ECOG) and the Cancer Trials Support Unit (CTSU),
which are sponsored by the National Cancer Institute (NCI). St. Mary also
participates in clinical trials supported by major pharmaceutical and biomedical
companies. The Research Program operates under the highest standards set
Robert Reilly, DO
by the FDA, NCI, ICH-Good Clinical Practices (GCP), and Office for Human
Research Protections (OHRP). According to the Medical Director of Oncology
Research at St. Mary Medical Center, Robert Reilly, DO, “St. Mary Medical Center
has been a significant contributor to medical research for more than 15 years. Our
collaborative efforts with leaders in the field of oncology research allow us to offer
patients clinical trials that previously were available only at large academic centers.”
FAMILY RISK EVALUATION PROGRAM
The Family Risk Evaluation Program was implemented at St. Mary Medical
Center in 2004. Thanks to the growing interest in this program by physicians and
members of the community, St. Mary has expanded the program’s options and
clinical services.
The goals of the Family Risk Evaluation Program at St. Mary Medical Center are
to educate individuals and families about the role of heredity in cancer risk, to
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provide them with up-to-date information regarding
cancer screening and prevention, and to support them
throughout the genetic counseling and testing process.
Initially the program was developed to evaluate the risks
of individuals with a personal or family history of breast
and/or ovarian cancer. In 2006, services were expanded
to include genetic counseling for colorectal and uterine
cancer risks. Counseling is tailored to the individual risk
profile of each participant based on personal and family
health history. The components of a family risk evaluation
session include the construction of a family tree, an
analysis of the pattern of cancer in the individual’s family,
the use of models to estimate the individual’s risk of
carrying a change in a cancer susceptibility gene, and a
discussion of genetic testing.
Experts affiliated with the Family Risk Evaluation
Program include medical and radiation oncologists,
board-certified breast surgeons, fellowship-trained
general surgeons, gynecologists, social workers,
spiritual care counselors, and genetic counselors.
DIAGNOSTIC RADIOLOGY
St. Mary Medical Center is committed to the continuous
investment in diagnostic radiology equipment affording
patients the latest and most accurate technologies available.
In 2007, St. Mary will implement lung Computer-Aided
Detection (CAD) technology, which will integrate digital
imaging with traditional chest x-ray. The CAD will help
to detect cancerous lesions to the lung in their earliest
stages. It will provide a virtual second opinion from the
collaboration between radiologist and computer. All chest
x-rays conducted for any reason on patients 30 years of
age and older at St. Mary automatically will be screened
by CAD for lung cancer.
St. Mary also will add Positron Emission Tomography
(PET)/Computed Tomography (CT) in 2007. PET/CT
integrates two advanced imaging technologies to help
doctors determine the staging of cancer and monitor the
progress of patients’ treatment. This technology will add
a vital dimension to our ability to evaluate patients by
pinpointing malignancies to see where cancer has
spread and how to best treat it.
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ST. MARY BREAST CENTER
In September 2006, St. Mary Medical
Center opened a Breast Center dedicated
to comprehensive breast care, continuing
St. Mary’s tradition of providing specialized
care for women. At the Breast Center, a
team approach offers patients a specialist
for every need. The dedicated staff includes
talented breast surgeons who work closely
with colleagues from Surgery, Pathology,
Radiology, Medical Oncology, and Radiation
Oncology. Specialized clinicians work
together to provide coordinated treatment
plans that are appropriate to the individual
needs of women.
A Breast Nurse Specialist coordinates
support resources, accompanying women
through the entire process of diagnostic
testing with advanced digital imaging and —
if faced with an abnormal mammogram
result — follow-up studies such as minimally
invasive breast biopsies. Each patient
receives emotional support as well as expert
care, ranging from chemotherapy and
radiation oncology to surgery and breast
reconstruction.
The Breast Center’s full array of the most
advanced women’s health technology
includes:
Digital Mammography
Computer-Aided Detection (CAD)
Breast Ultrasound
Breast MRI
Breast IMRT
Bone Densitometry
Ultrasound-Guided Biopsy
Stereotactic Biopsy
Sentinel Node Biopsy
Breast Localization Procedure
Breast Brachytherapy
RADIATION ONCOLOGY
The Radiation Oncology Department here at
St. Mary Regional Cancer Center has been
providing outstanding cancer care services
to the community since 1988. St. Mary
Cancer Center offers a team of prominent
physicians, medical physicists, dosimetrists,
nurses, therapists, and administrative
support staff, who accompany our patients
as they journey through this experience.
The Cancer Center currently has a stateof-the-art
Linear Accelerator with a 120
dynamic multi-leaf collimator, with IMRT
(Intensity Modulated Radiation Therapy)
capability. IMRT enables the radiation
oncologist to focus the maximum amount
of radiation specifically on cancerous tissue,
while sparing exposure to healthy surrounding
tissue.
Since 1994 the Radiation Oncology
Department also has offered prostate
brachytherapy seed implants, as well as
radionuclide therapy for patients with bone
metastases and blood disorders.
HDR (High Dose Rate) brachytherapy was
implemented in December 2006 for our
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St. Mary Regional Cancer Center treatment
technology (from left to right): TomoTherapy,
HDR (High Dose Rate) brachytherapy, and IMRT
(Intensity Modulated Radiation Therapy).
patients. HDR involves a protected radiation source placed directly within or near
the tumor site for a short period of time.
Looking ahead to 2007, the Radiation Oncology Department anticipates acquiring
some of the most advanced technologies available to treat cancer. The first
of these will be the installation of a Wide Bore CT Simulator. CT Simulation is
the most comprehensive procedure currently available to reconstruct, localize,
and define a patient’s tumor in three dimensions. This technology will allow the
radiation oncologist to identify the tumor as well as the normal tissue surrounding
it when designing a treatment plan specific to each patient. Also in 2007, the
Radiation Oncology Department plans to offer TomoTherapy, a technology that
represents the future of radiation therapy. TomoTherapy is a form of IMRT that
incorporates a quick CT scan before the commencement of each treatment to
ensure that the tumor is targeted accurately.
Finally, in 2007 the Radiation Oncology Department will be applying for its
ACR (American College of Radiology) radiation oncology accreditation. The
ACR radiation oncology program provides third-party impartial peer review and
evaluation of patient care.
INPATIENT ONCOLOGY UNIT
The Inpatient Oncology Unit of St. Mary is a 16-bed unit, staffed by registered
nurses, a licensed practical nurse, nursing assistants, and unit secretaries. Our
interdisciplinary approach to care for our patients supports a team effort to
provide quality healthcare and positive patient outcomes. Many of our staff nurses
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are active members of the Oncology Nursing Society. We strive to meet all of our
patients’ expectations and to provide the level of care that would inspire them to
recommend St. Mary Medical Center.
ONCOLOGY NURSING EDUCATION
St. Mary Medical Center offers continued support of the cancer program in its efforts
to meet the educational needs of our patients, their families, our colleagues, and
the community. To achieve this goal, nurses attended inservices that introduced new
chemotherapy medications and regimens. New nurses to the Oncology Department
are provided with a comprehensive orientation program that covers topics such as
types of therapies, nutrition, side effects, solid tumors, and hematologic malignancies. Nurses
with at least two and one-half years of oncology experience are encouraged to achieve and
maintain national certification. Their commitment to oncology nursing is demonstrated by joining
the Oncology Nursing Society, both the national and local chapters.
OUTPATIENT INFUSION CENTER
The Outpatient Infusion Center is centrally located within the St. Mary Regional Cancer Center.
A team of three nurses provides quality care to a diverse patient population, including patients
with oncologic diagnoses, rheumatoid arthritis, gastrointestinal disorders, and hematological
diseases, as well as other disease processes and disorders. The comprehensive care provided
by the nursing staff incorporates the physical, emotional, and spiritual aspects of patient care,
while professionally and promptly responding to the growing demands for outpatient infusion
therapy of all patient populations. The nursing staff achieves its goal daily of providing quality
healthcare to all patients.
PHARMACY
The pharmacy reviews, prepares, and dispenses chemotherapy medications for inpatients
and outpatients and for research protocols. The pharmacy maintains the inventory and drug
accountability of all research protocols.
In an effort to make chemotherapy preparation and administration as safe as possible, the
pharmacy uses PhaSeal, a closed-system chemo preparation device. The device prohibits the
transfer of environmental contaminants into the system and the escape of hazardous drug
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aerosols into the environment, enhancing pharmacy,
nursing, and patient safety.
To ensure that oncology patients have immediate
access to needed medications, especially medications
to control pain and chemo-adverse effects, the
pharmacy maintains a Pyxis (automated dispensing
system) unit on the oncology nursing unit and in the
infusion room.
Pharmacists provide drug information and support to
physicians, nurses, and the research department.
NUTRITIONAL COUNSELING
A registered dietitian provides cancer patients at
St. Mary Medical Center with a nutritional plan that
best meets their needs. The oncology dietitian
is involved in the care of outpatients as well as
inpatients. Each patient has the opportunity to request
the services of the dietitian during the course of
chemotherapy and radiation therapy. If a patient is not
going to initiate treatments immediately due to testing
or other factors, the dietitian still will contact the
patient and/or family member by phone to discuss
their nutritional status as requested by the physician
or the patient. The dietitian has the opportunity to
review the nursing assessment form and labs that are
available. All patients who are at nutritional risk are
given the opportunity to see the dietitian and receive
guidance to help them improve their nutritional status.
Other family members are encouraged to be present
for these consultations.
PAIN MANAGEMENT CENTER
The Pain Management Center at St. Mary
Medical Center operates under the leadership of
an outstanding team of physicians, nurses, and
specially trained staff and is located on the ground
floor of the outpatient facility. Our physicians are
anesthesiologists with a sub-specialty in pain
management and have extensive training and
experience to manage oncology pain. In collaboration
with the oncologist, they promote prompt and
effective assessments, diagnosis, and treatment of
pain with oncology patients.
The Pain Management Center educates patients and
families regarding options available for pain relief and
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encourages active participation in treatment decisions. Oncology
pain and associated symptoms can be aggressively treated with
several methods, including analgesics and ablative procedures, as
well as cognitive strategies. Our physician and nursing staff are
dedicated to excellence in our pursuit of pain control for oncology
patients in our community.
SUPPORTIVE CARE / PALLIATIVE CARE
The supportive care program is a consultant service that addresses
the needs of those with life-limiting illnesses. The supportive care
nurse and supportive care social worker facilitate communication
among the interdisciplinary team, patients, and their families. Supportive
care assists patients and families in identifying preferences
and goals, and provides supportive counseling on decision-making
options. The supportive care team is available to facilitate a plan and
arrange services based on the patient’s and family’s preferences.
Referrals can be initiated from physicians, nurses, social workers,
chaplains, or families and patients. Referrals can be made for both
inpatients and outpatients, patients from the Cancer Center, or any
physician’s office. The Supportive Care/Palliative Care program was
consulted on behalf of 626 patients in 2006.
HEALING MINISTRIES
In 2002, the Women’s Guild of St. Mary established a compassionate
initiative called Healing Ministries. Today, this program offers
customized holistic services, free of charge, to help our cancer
patients cope with the emotional and physical challenges that arise
during diagnosis, treatment, and recovery. As of December 2006,
564 individuals participated in this program, receiving over 3,200
services and classes.
Healing Ministries ensures a continuum of care. It is the way in
which St. Mary can extend quality of care beyond leading-edge
treatment to embrace the person who is affected by the disease
physically, emotionally, and spiritually. Healing Ministries also allows
for a multidisciplinary treatment approach by combining the best
medicine has to offer with holistic services such as massage, Reiki,
guided imagery, and more, recognizing that healing is a journey not
only of the body but also of the mind and the heart. The Healing
Ministries program is supported solely through private donations
and fundraising activities such as Circle of Hope Bracelets. It is
St. Mary’s way of introducing our patients to the concept of true
healing: a caring and compassionate resource that returns quality
of life to a person at a very difficult time.
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HOLISTIC SERVICES
Over the past 10 years, the St. Mary Holistic Center
has provided healing “companionship” to our patients,
fostering a sense of well-being and helping to reduce
the mental stress and fear that oftentimes accompany
serious diagnoses.
are offered for an outpatient’s convenience in our
Regional Cancer Center as well as in the privacy of
a patient’s hospital room. Facing a serious diagnosis
such as cancer can create extraordinary stress and
anxiety. Incorporating holistic services into a treatment
plan helps a person feel more in control, more
comfortable, and more a part of their healing journey.
The Holistic Center offers a tranquil environment for
patients to unwind, feel nurtured, and experience
deep relaxation through services such as massage
and Reiki. Additionally, mind-body tools such as clinical
hypnosis, guided imagery, or deep breathing techniques
coaching are extremely beneficial in boosting
one’s ability to cope or to prepare for chemotherapy,
radiation, or surgery. Lifestyle enrichment classes
such as yoga, tai chi, or meditation introduce skills for
self-care and self-support. Holistic care at St. Mary
does not mean “alternative” medicine. Rather, it is
our standard of care that addresses the human being
going through the illness and understands that healing
is a journey to be supported mind and body.
In addition to providing therapies within the calm and
serene setting of our Holistic Center, services also
SOCIAL SERVICES
The oncology social worker is available to patients
and family members on the oncology inpatient unit.
The social worker also is available to outpatients in
the Regional Cancer Center and those referred by
the physician. Services provided include psychosocial
assessment, community resource referral, information
on support groups, education, and crisis intervention.
The social worker also can assist patient and family
members in understanding insurance coverage and
benefits associated with discharge planning needs.
The oncology social worker works closely with supportive
care, home care, physicians, nurses, and other
interdisciplinary team members. Supportive services
are available to patients and family members.
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SPIRITUAL CARE
Spiritual Care is available to every one of our patients
from the beginning of treatment. St. Mary’s team of
clerical and lay chaplains supports patients and families
of all faiths as they cope with a cancer diagnosis.
On the inpatient oncology unit this begins at admission,
when a chaplain meets with each patient to assess
spiritual needs. In the Cancer Center, a chaplain
visits regularly with patients receiving daily treatment,
and is always on call for staff referrals. This continuity
between the Cancer Center and our inpatient unit
provides a unique opportunity to build a supportive
pastoral relationship at a time when faith and hope
can be most vulnerable.
Spiritual Care works closely with medical staff, social
services, and supportive care, and facilitates bereavement
programs throughout the year with Holistic
Care. In addition, Spiritual Care is in the process of
evaluating and addressing patients’ needs for peer
support, both one-on-one and in a group setting.
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TH R E E
2006 CANCER PROGRAM ACTIVITIES AND AMERICAN
CANCER SOCIETY (ACS) SUPPORT SERVICES
Throughout 2006, community programs were held in an effort to promote cancer awareness and
educate the general public. The following cancer-related programs were offered by
St. Mary Medical Center for their colleagues and the community.
BREAST CANCER SCREENING
AND AWARENESS PROGRAM
October 25, 2006
SCREENINGS
26 screenings were completed; 7 referrals
were made; low cost ($40.00) mammogram
vouchers were offered to all participants.
PROGRAM EXHIBITORS:
St. Mary Regional Cancer Center
St. Mary Medical Center Wellness and Holistic Centers
American Cancer Society
Healthy Women Program (PA Dept. of Health)
Sale of Circle of Hope Bracelets
SKIN CANCER SCREENING
TOWN HALL MEETING
hosted by CN8’s Lynn Doyle.
Program theme was the importance of the early
detection of breast cancer. Program featured a panel
of St. Mary physicians: Robert Reilly, DO, Medical
Oncologist; Brian Chon, MD, Radiation Oncologist;
William Mechanic, MD, Radiologist; and breast
cancer patient Nancy Broadbent. The program was
broadcast and aired several times on CN8.
St Mary Medical Center – Regional Cancer Center
May 3, 2006
• 100 individuals were screened, representing more
than a 20 percent increase over the combined total
of the two May 2005 screenings.
RECOMMENDATIONS:
Biopsy – 37
Referrals – 5
PROGRAM ATTENDANCE: 150 participants
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FOU R
DEPARTMENT OF PATHOLOGY AND
LABORATORY MEDICINE
The Department of Pathology and Laboratory Medicine provides diagnostic
services to both inpatients and outpatients. Cancer diagnosis is a major
focus of the department’s activity.
Surgical pathology cases, which include biopsies and resections, totaled
10,622. The department performed 1,061 non-gynecologic cytology examinations,
which included fine needle aspirations, bronchial brushings, and
body fluids. The Clinical Laboratory performed 1.7 million tests.
Zenon Gibas, MD
The Department offers access to the newest diagnostic modalities, including
molecular pathology, through the use of our own resources and a carefully
selected group of reference laboratories.
The Laboratory continues to be accredited by the College of American
Pathologists, with renewal in December 2008, and is accredited by the
American Association of Blood Banks, the State of Pennsylvania, and the
Federal Government through the CLIA program. The department is staffed
by three pathologists, all of whom are certified in Anatomic and Clinical
Pathology. Members of the department are involved in medical staff
activities related to oncology programs, such as Tumor Board and the
Cancer Committee.
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FIVE
CANCER REGISTRY REPORT
The Cancer Registry is an integral part of the St. Mary Medical
250Center Cancer Program. The Registry maintains an electronic
database system, which is used for the collection, management, 2006
200and analysis of data on over 14,000 patients diagnosed and/or
2005
treated with reportable cases of cancer at St. Mary Medical
150
Center since 1987. The database system continues to be upgraded
to ensure that all documentation will comply with Commission
100
on Cancer Program Standards. In compliance with state and
national mandates, the registry submits data to the Pennsylvania
Department of Health Statistics and to the American College of
Surgeons (ACoS) through their Commission on Cancer’s National
Cancer Data Base (NCDB). The NCDB utilizes this information
to conduct important annual studies to improve the care and
treatment of cancer patients. The data collected in the registry is
routinely reviewed for accuracy and completeness by the Cancer
Committee physicians and the appointed liaison physician.
50
0
0-29
30-39
40-49
50-59
60-69
70-79
80-89
90+
Graph 1
Frequency of Cancer
Top 5 Sites 2006
In 2006, there were 974 new cancer cases accessioned into the
Cancer Registry, of which 891 cases were analytic and 83 nonanalytic
cases. The registry has a total number of 14,885 cases
since the reference date of January 1, 1987. A successful
38%
26%
BREAST
LUNG
COLORECTAL
PROSTATE
follow-up rate on more than 5,600 patients is maintained,
and the registry responds to all inquiries from other facilities
for follow-up information in accordance with confidentiality
standards. The cancer registry also maintains a 90% follow-up
rate in compliance with the American College of Surgeons
5%
7%
12%
12%
BLADDER
ALL OTHER
Cancer Program Standards. Regular follow-up visits for a cancer
patient are important not only for the registry to maintain
accurate follow-up, but also for the patient, since early detection
is the link for long survival when cancer recurs.
Quality improvement projects, with which the registry
participates, reinforce the Cancer Program’s commitment to
quality of care and service. The registry actively participated
in 17 case presentation Cancer Conferences that provide
consultative information to physicians caring for cancer patients.
90+
ANNUAL REPORT 2006
St. Mary Cancer Center
| 19 |

Graph 2
Top Sites SMMC vs. State Projected
70
60
50
40
30
20
10
PERCENTAGE
30
24
18
12
6
0
BREAST
BRONCHUS
+ LUNG
Anus 3
Bladder 45
Blood/Bone Marrow 9
Brain 26
Breast 235
Cervix Uteri 4
ST. MARY
COLORECTAL
SITE
Colorectal 108
(Colon 79, Rectum/
Rectosigmoid 29)
Corpus Uteri 36
Esophagus 14
Eye 1
Fallopian Tube 1
Gallbladder 3
Kidney/Renal 16
Larynx 10
Liver 9
Lung 107
PROSTATE
STATE
BLADDER
Table 1
2006 Analytic Primary Site Table
250
200
150
100
50
Lymph Nodes/NHL/HL 34
Oral Cavity/Pharynx 22
Other 17
Ovary 11
Pancreas
38%
18
Penis 1
Prostate 64
Retroperitoneum 2
Skin/Melanoma 28
Small Intestine 2
Soft Tissue
5%
7
Stomach 5
Testis 6
Thyroid/Endocrine 39
Vagina 1
Vulva 7
TOTAL 891
0
0-29
7%
The Primary Site Table in this report (Table 1)
shows a breakdown of the anatomical sites for all
the cancers that were diagnosed and/or treated
here for the year 2006.
26%
BREAST
The Frequency of Cancer graphs (Graph 1 and
LUNG
Graph 2) represent the most common cancers
COLORECTAL
that were diagnosed and treated at St. Mary
Medical Center in 2006. Breast PROSTATE cancer is the
most frequently diagnosed cancer BLADDER at St. Mary,
with 235 new cases accounting ALL for OTHER 26% of our
analytic caseload in 2006. There were 108 cases
12%
of colorectal cancer, accounting for 12%; 107
new cases of lung cancer, accounting for 12%;
64 cases of prostate cancer, accounting for 7%;
and 45 cases of bladder cancer, accounting
for 5%.
12%
2006
2005
The registry maintains accurate Cancer Conference
compliance information. Through the year, the
registrars attend seminars that enable them to
update and sharpen the mechanisms of data
30-39 40-49 50-59 60-69 70-79 80-89 90+
management in the registry system.
0
0-29 30-39 40-49 50-59 60-69 70-79 80-89 90+
ANNUAL REPORT 2006
St. Mary Cancer Center
| 20 |

SIX
MULTIDISCIPLINARY CANCER CONFERENCES
St. Mary Regional Cancer Center
strives to conduct its Cancer
Conference meetings with a
multidisciplinary approach. The
Cancer Conference meets at least
twice per month and discusses
patients who reflect a variety of
cancer types (lung, breast, prostate,
head and neck, gastrointestinal/
colorectal, lymphoma, urologic, and
blood) treated at St. Mary Medical
Center. Each month, one conference
addresses a general cancer concern,
and sometimes includes an outside
speaker. In addition, specific
conferences relating to breast
cancer and thoracic oncology
have been carved out to meet
more regularly in response to the
physician community. All of these
conferences are multidisciplinary
and involve active participation
by members of the Medical
Oncology Department, Radiation
Oncology Division, Pathology,
Radiology, General Surgery, the
surgical subdivision, and general
medicine. The conferences are well
attended and provide not only a
forum for discussion of individual
patient treatment plans, but also an
informative educational conference
for members of the hospital
community.
The majority of the cancer
conferences are discussions of
current patients, with the cases of as
many patients as possible reviewed
prior to institution of treatment plan
to allow for input from a variety
of specialists. In 2006, physicians
discussed a total of 91 cases at 17
case presentation conferences and
4 didactic lectures. The Cancer
Conferences are committed to
furthering their educational role
in providing information to the
hospital community about cancer
diagnosis and treatment, both in
the discussion of individual patients
and in the general discussions held
during these conferences.
The following is a list of lectures from outside
speakers that were offered at the Cancer
Conferences in 2006:
FEBRUARY 2
Patricia Robinson, MD
“Evaluating Aromatase Inhibitors (AIs)
in Adjuvant Setting”
JUNE 15
Bruce Minsky, MD
“Adjuvant Therapy for Rectal Cancer”
AUGUST 17
Vatsala Bhardwaj, MD
“Diffuse Large B-cell Lymphoma”
DECEMBER 7
Tiffany Traina, MD
“Maximizing Metastatic Breast Cancer Treatment”
ANNUAL REPORT 2006
St. Mary Cancer Center
| 21 |

SEVE N
STATISTICAL REPORTS
STU DY 1:
The increased risk of falls for the aging cancer population
BACKGROUND
Cancer is primarily a disease of older adults. Approximately
60% of all cancers occur in those older than age 65. Therefore,
as the population of the United States continues to see rapid
demographic shifts in the old (i.e., those older than age 65)
and the old-old (i.e., those older than age 85), the number of
older adults receiving cancer care will be unprecedented.
Falls are one of most common geriatric syndromes. In the
United States, 30 to 40 percent of adults older than 65 fall
each year. Risk factors include age, muscle weakness,
activities of daily living, and impairments in gait, balance,
vision, and cognition.
RISK FACTORS
People with cancer often have multiple risk factors for falls. A
major risk factor is aging; because people often are diagnosed
with cancer at an older age or are living longer with cancer,
many are at risk for falls. Additional risk factors include
impaired physical function, sensory neurological deficits, use
of multiple medications, and deconditioning, often caused by
treatment-induced fatigue. Of all types of accidents, falls pose
the most serious threat to the elderly. A detailed understanding
and awareness of the risk factors (both intrinsic and extrinsic)
and problems associated with falls can assist oncology nurses
to be vigilant in the identification of patients at high risk
for falls.
DEMOGRAPHIC SHIFT
About 4 million people in the U.S. today are 85 or older; by
the year 2030, this age group will grow to 9 million people.
The number of Americans over 65 is expected to double by
2030 to 65 million; 9 million will be over 85, compared with
4 million today. The U.S. Census Bureau projects a 75 percent
increase in the population ages 65 and older by 2030, bringing
the number of Americans in this age group to 69 million,
accounting for more than 20 percent of the population.
Nutrition is a challenge for clinicians when treating elderly
cancer patients because weight loss is the common presenting
symptom. Body mass index or biochemical parameters
(albumin or total protein) can be used in the assessment
process.
Pain is another domain that should be assessed both before
and during treatment. Whether tumor-related (pressure
caused by tumors) or potential acute reactions (skin reactions),
clinicians should assess pain at each visit.
Graph 3 shows the average age for cancer patients slightly
increased at St. Mary Medical Center from 2005 to 2006.
Cognitive functioning plays a major role in the management
of the elderly cancer patient. Baseline assessment of mental
ANNUAL REPORT 2006
St. Mary Cancer Center
| 22 |

Graph 3
Number of cancer patients at St. Mary in each age group
Table 2
Number of falls in the Oncology Unit per month
STATE
250
200
150
2006
2005
2006 2007
January 4 0
February 2 2
March 3 3
April 1 2
May 1 3
100
June 2 0
July 3 0
E
BLADDER
50
0
0-29
30-39
40-49
50-59
60-69
70-79
80-89
90+
* data not yet
available
August 4 *
September 2 *
October 3 *
November 1 *
December 1 *
Totals 27 10
9 80-89 90+
deterioration (failing memory, emotional
irritability, confusion, anxiety, depression,
delusions, hallucinations, and even
dementia) is gathered at consultation
38%
and should be obtained at the onset of
radiation therapy. When treating the brain
with radiation, cerebral edema can quickly
change the mental and physical status of
the older adult, and distinctions need to
be made rapidly.
5%
12%
7%
Findings/Recommendations
Monitoring and tracking falls in the aging
cancer population will be essential to see if
improvement methods are effective or need
to be changed and modified.
Healthcare institutions need to reshape the
way they think about falls by changing the
26%
focus from being reactive to proactive. This
will continue to be a bigger problem as the
aging population grows.
Institutions need to develop risk assessment
tools for identifying at-risk cancer patients
12%
who may benefit from interventions to
reduce the incidence and severity of falls,
and to reduce BREAST the costs of falls.
LUNG
Risk of falls should be evaluated at any
COLORECTAL
clinician’s visit with elderly patients.
PROSTATE
Comprehensive geriatric assessment (CGA)
BLADDER
should be performed before radiotherapy to
establish baseline ALL OTHER functioning.
Exercise also has been shown to be beneficial
to people of all ages, as it helps to lower
blood pressure, lower the risks of falls and
serious injuries (such as hip or wrist fractures),
and slow the body’s loss of muscle
and bone mass.
St. Mary Medical Center has implemented
the following process improvement initiatives
in response to this issue:
• Increase rounding on all patients to
identify at-risk patients
• Use of bed alarms for all questionable
patients, even if there is no history
of falls
• Use Posey alarms for all patients who
are identified with cognitive impairment
(confusion, etc.) until their
status changes
Table 2 shows that the initiatives taken to
reduce falls have made a positive impact
but need to be monitored continually for
long-term effectiveness. Of note, falls decreased
by 1 fall per month when comparing
the first seven months of 2006 (2.3) vs.
2007 (1.4).
References
Aging Profile. U.S. Census Bureau. (2000).
Holley, Sandra (2002). “A Look at the Problem of
Falls Among People with Cancer.” Clinical Journal of
Oncology Nursing. 6(4): 193-197.
“Importance of Geriatric Assessments While Undergoing
Radiotherapy.” (2004). Geriatric Nursing.
25(6): 355-360.
Kagan, S.H. (2004). “Gero-oncology nursing research.”
Oncology Nursing Forum. 31:296-299.
Yancik, R., & Ries, L.A. (2000). “Aging and cancer in
America: Demographic and epidemiologic perspectives.”
Hematology and Oncology Clinics of North
America. 14:17-23.
ANNUAL REPORT 2006
St. Mary Cancer Center
| 23 |

STU DY 2:
Breast Cancer – “Utilizing Partial Breast Irradiation”
Background
Breast cancer is the most common cause
of cancer in women and the second
most common cause of cancer death in
women in the United States. While the
majority of new breast cancers are diagnosed
as a result of an abnormality seen
on a mammogram, a lump or change in
consistency of the breast tissue also can
be a warning sign of the disease.
Heightened awareness of breast cancer
risk in the past decades has led to an
increase in the number of women undergoing
mammography for screening,
leading to detection of cancers in earlier
stages and a resulting improvement in
survival rates. Even so, breast cancer
is the most common cause of death in
women between the ages of 45 and 55.
One out of every eight women in the
United States develops breast cancer.
The causes of breast cancer are not yet
fully known although a number of risk
factors have been identified.
Treatment
Women with breast cancer have many
treatment options, including surgery,
radiation therapy, chemotherapy, and
hormone therapy. The choice of treatment
depends mainly on the stage of the
disease, and many women receive more
than one type of treatment.
New advances in the treatment of breast
cancer have led clinicians to new techniques
in the radiation oncology field.
One of these promising new radiation
techniques is partial breast irradiation.
Partial breast irradiation (PBI) attempts
to focus the powerful treatment on just
the areas most likely to harbor stray cancer
cells, namely those near the original
tumor. PBI was developed to minimize
radiation treatment length while circumventing
recurrence and to ensure the
best cosmetic outcomes.
Another advantage of PBI is compression
of treatment time down to less than
one week, compared with six weeks for
standard whole breast external beam
treatments. Four techniques are available
to deliver PBI. These are interstitial
brachytherapy multicatheter systems, the
Mammosite Radiation Therapy System
applicator, external beam three-dimensional
conformal radiation therapy, and
intraoperative radiation therapy.
Treatment Outcomes
While more clinical studies need to be
conducted to support the data currently
available regarding PBI treatment
outcomes, preliminary Phase I & II trials
show that partial breast irradiation may
work as well as whole breast radiation.
Phase III trial data is still pending.
There are side effects associated with
each treatment, including possible
increased skin erythema, infections, and
persistent seroma formations. However,
if PBI treatments are proven safe and
effective, quality of life will be improved
for many women with breast cancer. PBI
also would provide a more convenient
radiation treatment plan for women who
have to travel long distances to get to
their cancer treatment center.
Further studies need to be conducted to
find out whether partial breast irradiation
is as good as or better than whole
breast radiation in keeping cancer from
coming back. Longer follow-up studies
also will be helpful to best understand
any possible long-term side effects. It
also will help us discover if partial breast
irradiation has more, fewer, or different
side effects than whole breast irradiation.
Until that time, experts suggest that “it
appears appropriate for those offering
PBI to adhere to the conservative principles
outlined in the reports available
from the American Brachytherapy
Society and the American Society
of Breast Surgeons.”
ANNUAL REPORT 2006
St. Mary Cancer Center
| 24 |

38%
Table 3
Percentage of breast cancer patients who received radiation as
part of their overall course of treatment at St. Mary
Course of Treatment
% of Breast Cancers By Treatment
SRG 44%
SRG, CHM 9%
SRG, RAD* 17%
SRG, RAD, CHM* 10%
HMN, SRG, RAD* 9%
HMN, SRG, RAD, CHM* 3%
Other 8%
* Received Radiation Treatment 39%
SRG=Surgery RAD=Radiation CHM=Chemo HMN=Hormone
70
60
50
40
30
20
10
0
Graph 4
Breast cancer incidence and age at diagnosis
0-29 30-39 40-49 50-59 60-69 70-79 80-89 90+
5%
Risk Factors
Studies have found the following risk factors
for breast cancer:
Age: The chance of getting breast cancer
increases as a woman gets older. Most cases
of breast cancer occur in women over age
60.
Personal history of breast cancer: A
woman who had breast cancer in one breast
has an increased risk of getting cancer in her
other breast.
Family history: A woman’s risk of breast
cancer is higher if her mother, sister, or
daughter had breast cancer. The risk is even
higher if her immediate family member got
breast cancer before age 40.
Certain breast changes: Some women
have cells in the breast that look abnormal
under a microscope. Having certain types of
abnormal cells —- atypical hyperplasia and
lobular carcinoma in situ (LCIS) —- increases
the risk of breast cancer.
Gene changes: Changes in certain genes
increase the risk of breast cancer.
Reproductive and menstrual history:
The older a woman is when she has her
first child, the greater her chance of breast
cancer. Women who had their first menstrual
period before age 12 are at an increased risk
of breast cancer. Women who went through
menopause after age 55 are at an increased
risk of breast cancer. Women who never had
children are at an increased risk of breast
cancer. Women who take menopausal hormone
therapy with estrogen plus progestin
after menopause also appear to have an
increased risk of breast cancer.
Race: Breast cancer is diagnosed more
often in white women than Latina, Asian, or
African American women.
Breast density: Breast tissue may be
dense or fatty. Older women whose mammograms
(breast x-rays) show more dense
tissue are at a slightly increased risk of
breast cancer.
Taking DES (diethylstilbestrol): DES
was given to some pregnant women in the
United States between about 1940 and
1971. (It is no longer given to pregnant
women.) Women who took DES during
pregnancy may have a slightly increased risk
of breast cancer.
Being overweight or obese after menopause:
The chance of getting breast cancer
after menopause is higher in women who are
overweight or obese.
Lack of physical activity: Women who are
physically inactive throughout life may have
an increased risk of breast cancer. Being
active may help reduce risk by preventing
weight gain and obesity.
Drinking alcohol: Studies suggest that the
more alcohol a woman drinks, the greater her
risk of breast cancer.
References
American Society of Clinical Oncology Annual
Meeting. (2006). Abstract 529.
Bankhead, C. (2003). “Accelerated partial breast
irradiation: more data needed, researchers say.”
Journal of the National Cancer Institute. 95:
259–261.
“Brachytherapy Saves Breast, Decreases Treatment
Time.” (2004). Cancer Weekly.
Comprehensive Cancer Information, National
Cancer Institute.
“HDR Breast Brachytherapy Treatment for Breast
Cancer.” (2005). Frank C. Love Cancer Institute at
St. Anthony. [cited 1 April 2005]
Jackson, J., and Guggolz, R. (2002). “Brachytherapy
Frequently Asked Questions.” American
Brachytherapy Society.
ANNUAL REPORT 2006
St. Mary Cancer Center
| 25 |

E IG HT
GLOSSARY OF TERMS
ABSTRACT – A summary that identifies a
patient and pertinent cancer information
that is the basis for all the registry’s functions,
or to process, collect, and record
pertinent cancer data from a patient
health record.
ACCESSION – A case entered into the
registry with an assigned number.
ANALYTIC (class of case) – Cases diagnosed
and/or receiving all or part of the
first course of treatment at St. Mary
Medical Center.
COC – The “Commission on Cancer”
is a division of the American College of
Surgeons that consists of professionals
involved in cancer control.
DIFFERENTIATION – How much or
how little a tumor resembles the normal
tissue from which it arose.
FOLLOW-UP – Method by which it
is determined whether or not a cancer
patient is living or has been examined by
a physician, the status of the cancer, the
quality of life.
FORDS – “Facility Oncology Registry
Data Standards” is a Commission on
Cancer-approved cancer program publication
that details COC required data set,
codes, and rules necessary to correctly
abstract and manage cancer cases in the
registry.
GRADE – Evaluating the microscopic appearance
of tumor cells to determine the
degree of differentiation.
METASTASIS – Spread of a disease from
one organ or part to another not directly
connected.
NCDB – The “National Cancer Data Base”
is a clinically oriented electronic database
of cancer cases submitted to the Commission
on Cancer by approved cancer
programs in the United States, which can
be used as a reference database to compare
the care and management of cancer
patients in one facility or region to similar
patients in other regions or nationally.
NON-ANALYTIC (class of case) – Cases
diagnosed and receiving first course of
treatment elsewhere; cancer cases diagnosed
and/or treated at St. Mary Medical
Center prior to the reference date; cases
diagnosed at autopsy.
PROTOCOL – Plan for treatment of a
type of illness.
RECURRENCE – Reappearance of cancer
after a period of remission.
STAGE – Classification of malignant
disease to denote how far the cancer
has advanced. This is determined at the
time of initial diagnostic studies and first
course of treatment.
SUMMARY STAGE CATEGORIES
IN-SITU: Malignancy present but not
invasive
LOCALIZED: Tumor confined to
organ or origin
REGIONAL: Tumor spread to immediate
adjacent organs or tissues and/or
regional lymph nodes
DISTANT: Tumor spread beyond
immediate adjacent organs or tissues
by direct extension and/or has
developed secondary sites, metastasized
to distant lymph nodes, or is
systemic in origin
UNKNOWN: Extent of disease cannot be
determined.
SURVIVAL – How long a patient has lived
since diagnosis or some other beginning
point. In general terms, the probability of
living a given length of time (such as fiveyear
survival) based on the characteristics
of a group of people.
TNM – System for describing the anatomic
extent of disease on the assessment of
three components and grouped as Stage I,
Stage II, Stage III, Stage IV:
T The extent of the primary tumor
N The absence or presence and extent
of regional lymph nodes present
M The absence or presence of distant
metastasis
Glossary Term Reference: Hutchinson, C.L., Roffers, S.D., & Fritz, A.G. (1997). “Cancer Registry Management Principles & Practice.” p. 482.
ANNUAL REPORT 2006
St. Mary Cancer Center
| 26 |

ST. MARY M E DICAL CE NTE R
CANCER SERVICES DIRECTORY
Appointments
Chemotherapy........................................................................215-710-5325
Radiation .............................................................................. 215-710-5300
Bereavement Support Group................................................................ 215-710-5902
Cancer Registry.................................................................................... 215-710-5314
Clinical Research/Protocol ................................................................... 215-710-5328
Community Cancer Screenings & Cancer Education
Program................................................................................. 215-710-5962
Health Sciences Library........................................................................ 215-710-2012
Holistic Services................................................................................... 215-710-6948
Home Care/Hospice ............................................................................ 267-569-0760
Mammography (to schedule) .............................................................. 215-710-2208
Nutritional Counseling ....................................................................... 215-710-2361
Rehabilitative Services
Physical medicine & rehabilitation ....................................... 215-710-2223
Pulmonary rehabilitation....................................................... 215-710-2522
Cardiac rehabilitation............................................................ 215-710-2191
Smoking Cessation Program ............................................................... 215-710-2204
Social Services ..................................................................................... 215-710-2542
Spiritual Care....................................................................................... 215-710-5902
Supportive Care/Palliative Care ........................................................... 215-710-4616

St. Mary Regional Cancer Center
1201 Langhorne-Newtown Road
Langhorne, PA 19047
215-710-5300
ANNUAL REPORT 2006
www.stmaryhealthcare.org
St. Mary Cancer Center
| 28 |