BrookwoodOncology Program

Annual Report2007-2008

DATA ENDING DECEMBER 2007

SYNOPSIS

Brookwood Medical Center’s Oncology Program

continues to serve our community by offering specialized

treatment plans, a variety of support services and amazing

care from our physicians and staff. We are able to provide

this quality care due to our team of Oncology Specialists

encompassing GYN, Surgical, Radiation, Medical,

Pathologists, Radiologists, as well as nurses, therapists and

dieticians. All of our specialists are dedicated to performing

high quality patient care throughout our facility ensuring that

our patients are always our first priority.

ACCOMPLISHMENTS

This year we have witnessed a lot of change within our

Oncology Program. The Cancer Care Center was

completely remodeled, increasing our number of exam

rooms from 3 to 5, acquiring new exam tables in each room

and purchasing the GE 16-slice, large bore CT Simulator.

The 7th floor Oncology Unit, under the direction of Cheryl

Smith, RN, is enjoying their new Stryker beds. These

specialized beds weigh patients while lying in bed; they also

convert into cardiac chairs from a bed position and deflate

automatically for chest compressions. 3Women’s, under the

direction of Christy Nation, RN, has seen the complete

renovation of their new nurses’ station, as well as their

patient rooms. Designed by Richard Tubbs, the patient

rooms now have a relaxed spa like atmosphere with a new

color scheme, furniture and artwork. The hospital’s cancer

registry, coordinated by Judy Smith, RHIA, CTR, has

accessioned 1343 cases. This is an increase of 67 cases

over last year, which is reflective of our growing cancer

program. Brookwood’s marketing department unveiled their

new marketing campaign, involving commercials and

billboards, which facilitated getting Brookwood’s name,

services and high level of care out into the community. Also,

this year, we have several nurses preparing for the Oncology

Nursing Certification Exam. This will be a wonderful

accomplishment for each of them as well as our hospital.

These are just a few of the exciting things that happened

this year. There is so much to be proud of here at Brookwood.

EVENTS

In September, some of our Brookwood employees

enjoyed a presentation given by Dr. Mack Barnes,

Gynecologic Oncologist, on Ovarian Cancer. His

presentation was extremely informative and his ongoing

dedication to our Gyn Oncology Program is greatly

appreciated. Our 3rd annual Mammothon, which took place

in October, was a big success, which is an important

community outreach for our active Breast Cancer Program.

Janet Dees, RN, Community Outreach Coordinator, visited

our neighborhood schools speaking to our youth on the

dangers of smoking. Janet also continues to grow our

genetic testing program and our high-risk breast cancer

assessment program.

Oncology Program Overview | 2007-2008

ACKNOWLEDGEMENTS

Thank you to Duke Martin for his continued leadership

of our Cancer Support Group “Together”. This group has

recently changed its name to “Friends Together” and will

continue to offer comfort for our patients and family

members. Thank you to our volunteers for their support

throughout the year with various projects and departmental

tasks. Thank you to our Oncology P.I. Committee members

who serve diligently throughout the year striving to better

our Oncology program. Our bimonthly meetings, lead by Dr.

Manuel Carcelen, have given us a multidisciplinary

approach to reaching our goals. Other leadership roles are

held by William DeVos, MD, who serves as Tumor

Conference Coordinator, Fred Dumas, MD and Sandra

Tincher, MD, who both serve as Physician Advisors and

Jaime Bitran, MD as Physician Liaison.

LOOKING TO THE FUTURE

Cyberknife of Birmingham, which is currently under

construction, will be located on Brookwood’s campus next

to the Cancer Center. Construction began in August and

should be complete by the beginning of 2009. We are

extremely excited that this cutting edge technology will be

available in our region. We are looking forward to being able

to provide another therapeutic option for some of the most

difficult to treat tumors. The Cancer Center will also boast a

new Varian iX Accelerator in 2009, with Rapid Arc

capabilities, which will reduce a patient’s treatment time

from 10 minutes to 2 minutes. This will really be beneficial

to our patients and their comfort level.

I look forward to participating in the growth of our

Oncology Program. Through our Administrative Leader, Billy

Connelley, MSHA, and the support of the Senior Team,

2009 will be an outstanding year for Oncology.

Jenni Fisher, BS, CMD, RT(T)Manager, Brookwood Cancer Care Center

THE ONCOLOGY PROGRAM AT BROOKWOOD MEDICAL CENTER

provides state of the art treatment to cancer patients in our

community. Last year there were 1,211 patients who received a

new diagnosis of cancer at this institution, reflecting the

continued growth of this program. As in previous years the top

five sites were breast, uterine, lung, and colon, with ovarian

cancer overtaking prostate cancer for the fifth place this year.

The Cancer Registry collects information on these patients and

participates in the National Cancer Database as required for all

accredited programs by the American College of Surgeons

Commission on Cancer.

A review of the Brookwood experience in patients with

breast cancers less than 2 cm and negative nodes treated with

accelerated partial breast irradiation using MammoSite between

2003-2007 showed favorable outcomes, with a 3% recurrence

rate and good/excellent cosmetic results in 83% of patients.

These figures are consistent with those reported by the

Mammosite Registry.

As part of the commitment to incorporate new technologies

and provide quality care to our patients in a comfortable

environment the Cancer Center has undergone extensive

renovation, which has allowed expansion of the facilities and the

incorporation of a new CT simulator with a respiratory gating

system, We are currently in the process of building the

infrastructure for a CyberKnife, which hopefully will be operational

in early 2009, and working towards completing upgrades to the

physical plant in the inpatient oncology ward.

Community outreach remains an important goal for the

program, and as in previous years a number of activities to meet

this need took place, including educational programs for

elementary schools, senior citizens groups, and the workplace.

Education on prevention and early detection of colon, breast, and

lung cancer are an essential component of the program.

As we prepare for our reaccreditation survey by the American

College of Surgeons Commission on Cancer in 2009, and adjust

to the challenges of an ever changing healthcare market, we

remain optimistic that in the coming years Brookwood Medical

Center will continue to be a leader in the efforts for prevention ,

diagnosis and treatment of cancer.

Manuel F. Carcelen, MD

Chairman, Oncology Performance Improvement Committee

Chairman’s Report

STAGE IV

23%

STAGE I

26%

STAGE II

21%

STAGE III

21%

S + R + C 6%

SURGERY

52%S + CHEMO

28%

CHEMO 4%

Colorectal Brookwood = 90 | Alabama = 2,350 | U.S. = 153,760

UNKNOWN 7% STAGE O 2%

STAGE I

67%

STAGE IV 6%

Uterine Corpus Brookwood = 135 | Alabama = 460 | U.S. = 39,080

S + R 2%OTHER 1%

SURGERY

84%

S + R + C

1%

RADIATION

1%

S + CHEMO

12%STAGE III

15%

STAGE II

6%

TOP FIVE PRIMARY SITES (2007) | CANCER BY STAGE, TREATMENT & COMPARISON

SURGERY

21%

S + R

13%

S + H 6%

Breast Brookwood = 262 | Alabama = 2,750 | U.S. = 180,510

S + CHEMO

13%

S + R + C 8%

OTHER 2%

S + R + H 12%STAGE I

30%

STAGE O27%

STAGE III 12%

STAGE IV 3%

STAGE II

24%

S + R + C + H 9%UNKNOWN 4%

SURGERY

22%

R + CHEMO

15%

Lung Brookwood = 116 | Alabama = 3,850 | U.S. = 213,380

S + R + C

5%

S + C 11%

OTHER 7%

CHEMO

14%

NONE 19%

UNKNOWN–N/A 9%STAGE I

25%STAGE IV

38%

STAGE III 21%

UNKNOWN–N/A7%

STAGE II

8%

RADIATION 7%

STAGE III

57%

STAGE IV 6%

STAGE II

5%

STAGE I

25%

UNKNOWN 6%

SURGERY

37%

S + C 59% S + C + OTHER

3%

Ovary Brookwood = 69 | Alabama = n/a | U.S. = 22,430

CHEMO 2%

NONE

10%

MammoSite Update The ability to offer APBI using Mammosite to our Brookwoodoncology patients began in June 2003. At the time of this update,December 2007, 172 patients have been treated with this technique.

The Brookwood data for local control and cosmesis for patientstreated with Mammosite were reviewed to include patients treatedduring the 4-year period from June 2003-June 2007 with a minimumof 3 months follow-up. This included 155 patients (range follow-up:3 months-51 months, mean follow-up: 15 months). Cosmeticoutcome was scored using Harvard criteria of good/excellent orfair/poor.1 Any telangiectasia was graded as a fair/poor outcome.

Of the 155 evaluable patients, there were only 7 lost tofollow-up at Brookwood. In addition, 2 patients have tested BRCApositive and have subsequently undergone bilateral mastectomies.

Our criteria for Mammosite treatment has been: age at least45 years old, tumor size no more than 2cm, negative marginsand negative lymph nodes. Our actual Mammosite populationconsists 11pts less than 45 years of age (range: 41-44yrs), DCIS(43pts), T1N0 (102pts), and T2N0 (10pts).

There have been 5 recurrences in our Mammosite patients

BREAST CONSERVATION THERAPY FOR BREAST CANCERincludes radiation to remaining breast tissue after lumpectomy todecrease local recurrence rates from 35% to 10% or less. Thisusually involves 5 weeks of external radiation to the whole breast(elective treatment of the entire breast for presumed occult disease)followed by a reduced field to the tumor bed for an additional 2 weeks.

Advances in radiation technology now allow acceleratedpartial breast irradiation (APBI) as a potential option fortreatment. This provides radiation to the tumor bed alonedelivered internally twice a day over one week, thereby greatlyreducing the overall treatment time required to deliver radiation.This may allow the benefits of radiation to patients whomotherwise may not have access to treatment due to barrierssuch as advanced age, transportation, or physical limitations.Also, since less tissue is radiated, there is the potential todecrease lung and cardiac toxicity and improve cosmesis.

S + C + H 5%

NONE

11%

SUMMARY OF CANCER INCIDENCE 2007—For 2007, atotal of 1, 211 cases of cancer were diagnosed at BrookwoodMedical Center. The most common presenting diagnosis iscarcinoma of the female breast, comprising a total of 261 cases.This represents an increase of 30 cases over the previous year.Nationally, the number of breast cancers has been dropping butthis is not yet apparent at Brookwood. The second mostcommon diagnosis we see is carcinoma of the uterus with 133cases, followed by lung cancer with a total of 116. Colon andrectal cancer represent 90 cases and ovarian cancer has nowbecome No. 5 on the list with 63 cases diagnosed last year.Prostate cancer has become a less common diagnosis atBrookwood due to more patients being treated in the communityrather than the hospital setting. When compared to nationalstatistics, Brookwood treats a slightly higher number of femalebreast cancers and significantly less lung cancers. We continueto see an excessive number of gynecologic cancersrepresenting patterns of referral to the Women’s Care Center.

R. Fred Dumas, Jr., MD | Radiation OncologistMedical Director, Brookwood Cancer Care Center

DISTRIBUTION BY AGE & SEX (2007)

0-29 30-39 40-49 50-59 60-69 70-79 80-89 90+

35%

30%

25%

20%

15%

10%

5%

0%

Age Distribution

FIVE YEAR COMPARISON OFANALYTIC CASES BY SITE (2003-2007)

Site 2003 2004 2005 2006 2007

Breast 158 178 226 233 262Lung 107 106 127 97 116Prostate 77 45 73 103 60Colorectal 75 87 92 100 90Corpus Uteri 137 122 130 116 133Ovary 53 63 81 69 63Total 967 992 1111 1134 1211

INCIDENCE BY COUNTY (2003-2007)

County 2003 2004 2005 2006 2007

Jefferson 452 473 477 539 565Shelby 159 175 190 200 192Talladega 44 43 55 65 71Montgomery 27 21 24 26 36Chilton 18 23 29 37 31Tuscaloosa 17 18 23 24 30St. Clair 24 29 36 33 29Calhoun 23 26 35 18 24Other 308 294 343 334 365Total 1072 1102 1212 1276 1343

(recurrence rate of 3%). Three of these patients developedmetastatic disease without local recurrence, one patient developedaxillary nodal recurrence, and one patient developed inflammatorybreast cancer with bone metastasis (see chart right).

Our cosmetic outcome has been good/excellent in 128pts(83%) and fair/poor in 27pts (17%). In the patients with fair/poorcosmesis, 52% had a skin distance of 7mm or less compared toonly 9% with good/excellent cosmesis. There were 9pts thatonly received Mammosite as a boost due to skin distance andall had good/excellent cosmesis. Grade 2 skin toxicity (moistdesquamation) at 3 week follow up visit strongly predicted for poorcosmetic outcome. Chemotherapy was delivered in 37% of thefair/poor cosmesis group compared to 13% of the good/excellentcosmesis group. The time to develop poor cosmetic outcomeranged from 3-36 months with mean of 14 months.

Recently, 5-year results for Mammosite were reported on 36women tumor size limited to 2 cm, node negative, no extensiveintraductal component and age greater than 44 years old. The datashowed good to excellent cosmetic outcomes in 83% patients

� MALE � FEMALE

PATIENT CHARACTERISTICSOF MAMMOSITE RECURRENCES

Patient 1 2 3 4 5

Age 67 60 54 53 44

Tumor Size 9 mm 11 mm 22 mm 25 mm DCIS

LVI No Yes Yes Yes n/a

Grade II III II III HNG

Tx Date 1/04 11/04 11/04 1/05 4/05

Chemo CMF Refused CA Refused n/a

Recur. Time 19 mo 11 mo 24 mo 12 mo 9 mo

Recur. Type DM-lung DM-liver Axilla DM-liver Inflam.Breast-Ax,DM

Expired 12/05 n/a n/a 3/06 n/a

with a skin distance of less than 7mm resulting in significantlypoorer cosmesis. The data also showed local recurrence rate ofonly 3% (both went on to develop death from metastatic disease)with younger age being significant predictor for recurrence.2,3

Patterns of failure with Mammosite have also recently beenreported on 70 women with 2 year follow up with a 7% localfailure rate. It was noted that the recurrences were seen inyounger patients, lobular histology, or extensive intraductalcomponent, and nodal positivity.4

The most recent report from the Mammosite Registry in2007 with 1449 patients showed an overall good/excellentcosmetic outcome of 91%. The local recurrence rate is 2% witha median follow-up of 35 months.5

In summary, with our current inclusion criteria and treatmenttechniques, the patients treated with Mammosite at Brookwoodhave had excellent local control rates and cosmetic outcomesvery consistent with the national statistics.

Sandra Tincher, MD | Radiation OncologistCancer Registry Advisor, Brookwood Cancer Care Center

1 Harris JR, et al: Red J 5: 257-261, 1979.2 Benitez PR, et al: Am J Surg 194: 456-462, 2007.3 Chao KK, et al: Red J 69: 32-40, 2007.4 Chen S. et al: Red J 69: 25-31, 2007.5 Vicini FA, et al: Breast Cancer Symposium 2007, Abstract No. 274

2007 ONCOLOGY PROGRAM STATISTICS

ONCOLOGY CONFERENCES

Total cases presented . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121

Prospective cases presented . . . . . . . . . . . . . . . . . . . . . . . 111

Percent of Prospective cases . . . . . . . . . . . . . . . . . . . . . . 92%

Cancer conferences. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Average staff attendance . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

CANCER REGISTRY

Total cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,343

Analytic cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,211

Non-analytic cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132

Cases in registry since reference date. . . . . . . . . . . . . 16,873

Follow-up contacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,754

Percent of Cases Evaluated for Quality Control. . . . . . . 10%

Number of Analytic Cases Reviewed for Quality Control . . 121

REFERENCES

Cancer Facts & Figures 2007 | American Cancer Society

Alabama Cancer Facts & Figures 2007 | American Cancer

Society & Alabama Statewide Cancer Registry

AJCC Cancer Staging Manual, 6th Edition | American Joint

Committee on Cancer | Springer-Verlag | New York, NY 2002

International Classification of Diseases for Oncology, 3rd Edition

World Health Organization | Geneva, Switzerland, 2000

Facility Oncology Registry Data Standards (FORDS) | American

College of Surgeons | Commission on Cancer | Chicago, IL, 2007

Collaborative Staging Manual and Coding Instructions | American

Joint Commission on Cancer | U.S. Department of Health and

Human Services | Bethesda, MD, 2007

SEER Summary Staging Manual 2000 | Cancer Surveillance,

Epidemiology and End Results Program | National Institute of

Health | National Cancer Institute | Bethesda, MD, 2001

Multiple Primary and Histology Coding Rules | Field Study

Manual | National Cancer Institute | Surveillance Epidemiology

and End Results Program | Bethesda, MD, 2007

ONCOLOGY PERFORMANCEIMPROVEMENT COMMITTEE | 2007-2008

CHAIRMAN

Manuel Carcelen, MD

Pulmonary Medicine

Chairman, Oncology

P. I. Committee

NON-PHYSICIAN

MEMBERS

Ellen Carmichael, CRNP

Women's Health

Clinical Excellence Manager,

Quality Improvement

Coordinator

Billy Connelley, Jr., MSHA, RT(T)

Vice President, Operations

Janet Dees, RN, MBA

Oncology and Community

Outreach Coordinator

Judy Smith, RHIA, CTR

Cancer Registry Coordinator

Jenni Fisher, BS, CMD, RT(T)

Clinical Manager,

Brookwood Cancer

Care Center

Karen Litwiniec, PharmD

Manager, Pharmacy Services

Christy Nation, RN

Director, Women’s 3

Kristin Pruett, RHIT

Director, Health Information

Management

Cheryl Smith, RN

Director, 7 Main

Tracy Flanagan, RHIT, CTR.

Cancer Registrar

Laura Ann Walley, RN, MSN

Director, Medical Staff/

Performance Improvement

PHYSICIAN MEMBERS

R. Fred Dumas, Jr., MD

Radiation Oncology

Medical Director,

Brookwood Cancer

Care Center

Cancer Registry Advisor

Sandra Tincher, MD

Radiation Oncology

Cancer Registry Advisor

Ruth Atkinson, MD

Hematology/Oncology

Luigi Bertoli, MD

Hematology/Oncology

Luis Pineda, MD

Hematology/Oncology

Mack Barnes, MD

Gynecologic Oncology

Jamie Bitran, MD

General Surgery

Cancer Liaison,

Community Outreach

Leader

Agnes Cartner, MD

Radiology

J. Christopher Davis, MD

Otolaryngology

Bradley Dennis, MD

Administration

Chief Medical Officer

William DeVos, MD

Pathology

Tumor Conference Coordinator

Donald Simmons, MD

Pathology

Bryant Poole, MD

Urology

PRIMARY SITE TABLE | 2007 ANALYTIC CASES

M = Male | F = Female Unk. = Unknown Stage | N/A = Benign cases or cases not staged by AJCC

SEX AJCC STAGE AT DXPRIMARY SITE TOTAL M F 0 I II III IV UNK N/A

Lip 2 2 0 0 0 0 0 0 2 0

Base of Tongue 2 2 0 0 0 0 0 2 0 0

Parotid 3 2 1 0 0 1 1 0 0 1

Esophagus 9 7 2 0 3 4 0 2 0 0

Stomach 16 9 7 0 4 2 3 3 2 2

Small Intestine 4 1 3 0 0 1 1 0 0 2

Colon 64 26 38 1 15 18 13 17 0 0

Rectosigmoid 8 6 2 0 2 1 4 0 1 0

Rectum 18 13 5 1 6 0 2 4 2 3

Liver/Intrahep Bile 5 1 4 0 1 0 1 2 1 0

Gallbladder 2 1 1 0 1 0 0 1 0 0

Other & Unspec Parts of Biliary 2 1 1 0 0 0 0 2 0 0

Pancreas 21 14 7 0 3 2 4 10 1 1

Larynx 8 7 1 0 4 1 2 1 0 0

Bronchus/Lung 116 66 50 0 29 9 24 44 7 3

Thymus 2 1 1 0 0 0 0 0 0 2

Mediastinum, Heart & Pleura 1 1 0 0 0 0 1 0 0 0

Bones, Joints, Art. Cartilage 5 3 2 0 0 0 0 2 3 0

Hematopoietic/Re-ticuloendothelial 42 27 15 0 0 0 0 0 0 42

Skin 19 13 6 2 6 3 1 2 4 1

Retroperitoneum 11 0 11 0 0 0 0 0 0 11

Conn Subq tissue 12 4 8 0 1 2 1 1 7 0

Breast 262 1 261 70 79 64 31 7 10 1

Vulva 45 0 45 27 9 5 0 0 3 1

Vagina 5 0 5 3 0 1 1 0 0 0

Cervix 30 0 30 0 15 3 5 3 4 0

Corpus Uteri 133 0 133 0 90 8 20 8 5 2

Uterus NOS 2 0 2 0 0 0 0 0 0 2

Ovary 63 0 63 0 16 3 36 4 2 2

Other Female 3 0 3 0 1 0 1 0 0 1

Placenta 3 0 3 0 0 0 0 0 0 3

Prostate 60 60 0 0 0 58 0 2 0 0

Testis 4 4 0 0 4 0 0 0 0 0

Kidney 58 34 24 0 43 7 2 6 0 0

Renal Pelvis 6 3 3 1 3 1 1 0 0 0

Ureter 1 1 0 1 0 0 0 0 0 0

Bladder 42 29 13 20 9 4 2 7 0 0

Brain 21 13 8 0 0 0 0 0 0 21

Meninges 28 10 18 0 0 0 0 0 0 28

Other Central Nervous System 7 3 4 0 0 0 0 0 0 7

Thyroid 15 6 9 0 11 1 1 2 0 0

Other Endocrine 5 2 3 0 0 0 0 0 0 5

Lymph Nodes 25 12 13 0 4 6 7 4 4 0

Unknown Primary 21 9 12 0 0 0 0 0 0 21

TOTAL ANALYTIC 1211 394 817 126 359 205 165 136 58 162

BROOKWOOD ONCOLOGY SERVICES DIRECTORY

Brookwood Medical Center . . . . . . . . . . . . . . . . . . . . . . 205-877-1000

Vice President of Operations . . . . . . . . . . . . . . . . . . . . . 205-877-1893

Brookwood Cancer Care Center . . . . . . . . . . . . . . . . . . 205-877-2273

Manager . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-1094

Scheduling Coordinator . . . . . . . . . . . . . . . . . . . . . 205-877-2228

Oncology Nurse Coordinator . . . . . . . . . . . . . . . . . 205-877-2209

Nurse for Dr. Fred Dumas . . . . . . . . . . . . . . . . . . . . 205-877-2209

Nurse for Dr. Sandra Tincher . . . . . . . . . . . . . . . . . 205-877-2217

Oncology Coordinator. . . . . . . . . . . . . . . . . . . . . . . 205-877-1798

GYN Inpatient Oncology Unit . . . . . . . . . . . . . . . . . . . . . 205-877-5350

Inpatient Oncology Unit . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-1700

Nurse Navigator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-2687

Nutritional Support/Oncology Dietician . . . . . . . . . . . . 205-877-1033

Oncology Chaplain/Counselor . . . . . . . . . . . . . . . . . . . . 205-877-1720

Ostomy Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-2582

Outpatient Medical Oncology. . . . . . . . . . . . . . . . . . . . . 205-877-2256

Physician Referral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-8800

ADDITIONAL SUPPORT SERVICESAlabama Foundation for Oncology . . . . . . . . . . . . . . . . 205-877-2225

American Cancer Society . . . . . . . . . . . . . . . . . . . . . 1-800-ACS-2345

Genetic Testing

Breast, Ovarian, Colon and Melanoma Cancer . . 205-877-1798

Camp New Hope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-2224

Camp for children of cancer patients

Camp Newsong . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-2224

Camp for children who have had a family member die

Cancer Registry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-1383

Hope Lodge. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-888-513-9933

Smoking Cessation . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-QUITNOW

Transportation Information . . . . . . . . . . . . . . . . . . . . . . . 205-877-1798

Women's Diagnostic Center . . . . . . . . . . . . . . . . . . . . . . 205-877-5200

Digital mammography, CAD, ultrasound and bone density

CANCER SUPPORT GROUPSBosom Buddies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-ACS-2345

For women with breast cancer

Gynecologic Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-975-9523

For women with GYN cancer

Look Good Feel Better . . . . . . . . . . . . . . . . . . . . . . . . 1-800-ACS-2345

Free class on makeup application and hair care during cancer treatment

Man to Man . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-ACS-2345

For men with prostate cancer

Reach to Recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-800-ACS-2345

Information on exercises for breast surgery recovery, including range

of motion exercises for surgical arm

STRETCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-824-6666

Exercise class designed especially for women following breast surgery

Friends Together . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205-877-1720

For patients with any type cancer and loved ones

Brookwood Medical Center

2010 Brookwood Medical Center Drive

Birmingham, Alabama 35209

(205) 877-1000

www.bwmc.com

Rev. 11/08