M E R C Y H E A L T H S Y S T E M 2 0 1 0A N N U A L R E P O R T

Cancer Program

1 table of contents

Message from the President ......................2

Mercy Cancer Committee

chairman’s report..................................3

2010 Cancer Committee ......................3-4

Mercy Regional Cancer Center

team phone numbers ............................4

A new view for patients ........................5-6

Mercy Cancer Registry report ..............7-11

How the Mercy Cancer Registry

benefits our patients ..............................8

Mercy Hospital and Trauma Center’s

hospitalist program ............................11

Tumor Board conferences ......................12

Kidney cancer at Mercy Hospital

and Trauma Center: 1994-2009 ....13-15

American Cancer Society ......................16

Radiofrequency ablation of

renal cell carcinoma ..........................17

Mercy Hospice Care:

offering comfort, support and caring ......18

Mercy Palliative Care Program................19

Pathology’s role in cancer treatment ........20

Mercy Regional Cancer Center:

hematology/medical oncology clinic ....21

From our partners: Angela Butters ............22

Mercy’s clinical trial program ............23-24

Genetic testing for hereditary

cancer syndromes ..............................25

What our patients say: Sharon Krueger ....26

Mercy Regional Cancer Center:

radiation oncology ............................27

From our partners:

Bonnie Anderson Eichstedt ..................28

Mercy Regional Cancer Center:

surgical oncology ..............................29

From our partners: Phyllis Garner ............30

From our partners: Heidi Canfield............31

What our patients say: Joan Brayer ........32

What our patients say: Coreen Smith ......33

Mercy Regional Urology Center:

compassionate care for special concerns34

Mercy Institute of Neuroscience ..............35

da Vinci Si HD Dual-Console

Surgical System..................................36

Support services ..............................37-41

Support groups ....................................41

Mercy MyChart

helps you manage your life ..................42

We’re dedicated to offering the best cancer care in the area. In fact, our oncology program has been recognized with commendation by the Commission on Cancer of the American College of Surgeons as offering the very best in cancer care. It is arecognition of the quality of our comprehensive, multidisciplinary patient care. We’reproud to have brought the very best in today’s cancer treatment closer to home.

2Message from the president

Dear friends,

When I started here in 1989, Mercy Hospital’s cancer programoffered excellent, but limited, cancer services. Patients and their families had to drive to nearby cities to receive most of their care.Having cancer is enough of a hardship without the added burdenand stress of having to drive far for appointments. I thought we could do better—and we did.

On October 7, 1990, we celebrated the establishment of the MercyRegional Cancer Center and the new building housing our state-of-the-art radiation therapy program. That Regional Cancer Building is nowjoined by the Sister Michael Berry Building to its south. Almost 20years to the day—October 23, 2010—the Sister Michael BerryBuilding celebrated its own open house. In addition to neuroscience,trauma care, men’s health, urology and gastroenterology, the building

also houses our new medical oncology department, formerly located on the ground floor of MercyHospital. Learn more and see the department’s beautiful views on p. 5-6.

As part of our open house, and in recognition of the many transformations that have taken place onthe entire Mercy Campus in Janesville, we changed the name of our hospital to Mercy Hospitaland Trauma Center.

We have grown in many other ways in these 20 years. We’ve made significant investments intechnology to detect and treat a wide range of cancer types. We take part in national clinical trialsand offer cancer-related genetic testing and counseling. Our palliative care program is availablefor consultation and symptom management. We help get patients back on their feet through manymodes of rehabilitation, support services and home health care.

In 2010, we welcomed two new doctors. Dr. James Richardson is a progressive radiation oncologist who now leads the development of that program. Dr. Douglas Puffer joined our excellent hematology and medical oncology team. I also welcome Michelle Leverence, MSW, as our newest oncology social worker. Michelle has developed a new support group to bringpatients, families and others together to discuss their challenges and victories.

As cancer care continues to evolve and improve, the Mercy Regional Cancer Center will keeppace—just as it has for 20 years.

Sincerely,

Javon R. BeaPresident/CEO, Mercy Health System

The work continues …. Each year, manyaspects of our cancer programare enhanced.

Since the summerof 2009,

advanced robotic surgery was added to our armamentarium for treating malignancies. Roboticprocedures are now routinely available in urology,gynecology and general surgery.

Electronic medical records are being rolled out to more and more clinics and offices to completethe outpatient side of Epic implementation. At thesame time, work is ongoing to convert inpatient care from paper to electronic charts.

Hospitalists have become integral members of theteam as they took on the responsibility of caring for inpatient medical oncology patients. Their contribution to our program is featured in our recent Annual Reports, including this one. A member of the hospitalist team has been added to the Cancer Committee to assure timely communication and collaboration.

A new and much larger medical oncology clinic isnow operating on the top floor of the Sister MichaelBerry Building on the Mercy Hospital and TraumaCenter campus. This ensures continued growth ofmedical oncology services. The lower level of thatbuilding provides needed covered parking spaces.

Early this year we were happy to welcome Dr. James Richardson, radiation oncologist, whojoined our team and took over the department ofradiation oncology. Dr. Richardson has been theobject of compliments and praises from patients,staff and physicians.

An informal campaign across our large service area uses print, billboards, electronic media to feature cancer program physicians and patients. It is a big success! Some individuals were featuredon YouTube, which had many “hits.”

My sincere thanks to all of you who work so hard to make our Cancer Program such a great success.

Mercy Cancer Committee: chairman’s report3

B. K. Wasiljew, MD, FACS

Chairman, Mercy Cancer Committee

Physician membersGregory Denison, MD RadiologyRonald Garcia, MD Rehab ServicesPatricia Garner, MD General Surgery/LiaisonThomas Haas, DO Pathology

Francis Kaveggia, MD UrologyMasood Khan, MD Hospitalist

Meridyth Munns, MD GYNGary Peplinski, MD General SurgeryDouglas Puffer, MD Medical Oncology

James Richardson, MD Radiation OncologyEmily Robinson, MD Medical Oncology/Hematology

Shahid Shekhani, MD Medical Oncology/HematologyB.K. Wasiljew, MD General Surgery/Committee Chair

4Science ... services ... support

Since 1990, the Center has helpedthousands of cancer patients andtheir families meet the challenges ofcancer head on. Our comprehensivecancer care program offers the fullrange of resources necessary todetect and treat cancer, and helpour patients not only recover, but thrive. Our entire staff—with our combined knowledge and expertise—understands whateach patient is experiencing. We know that our patients requirenot only state-of-the-art technology to heal, but also the human touch. It is this spirit of compassion andkindness that makes our Centerstand out. How do we know? Our patients tell us, every day.

2010-2011 Cancer Committee MembershipNon-physician membersTani Abendroth MarketingJan Botts, RN Director, Quality Management

Linda Brethauer, APNP, AOCN Medical Oncology / HematologyAmy Carey Community Outreach

Shawn Davenport, PT DirectorRev. Doug Dowling Chaplain

Nedra Hanson, RHIT Medical ManagementRachel Hill Smith MarketingErik Hollander American Cancer Society

Karol Huenerberg, APNP, OCN AdministrationDon Janczak, PharmD Pharmacy

Carol Johnson, RN Mercy Assisted Care Hospice CareJanice Johnson, RN Clinical ResearchMichelle Leverence Social ServicesTricia Obrecht, CTR Cancer Registry

Sue Ripsch Vice PresidentMartha Roberts Cancer Registry

Your Mercy Regional Cancer Center teamAmerican Cancer Society ........................................................(800) 227-2345

American Cancer Society Navigator .........................................(608) 833-4555

Mercy Cancer Registry ............................................................(608) 756-6139

Mercy Hospice Care ...............................................................(800) 369-2201

Mercy Hospital and Trauma Center..................(608) 756-6000/(800) 756-4147Administrative director, oncology .............................................(608) 756-6871Clinical trials data manager ...................................................(608) 756-6871Dietitian/nutritionist ...............................................................(608) 756-6151Financial counselor ...............................................................(608) 756-6500Genetic counseling ...............................................................(608) 756-6871Hematology/medical oncology .....................(608) 756-6871/(800) 928-1103Inpatient special care unit (SCU) .............................................(608) 756-6897Manager, oncology ..............................................................(608) 756-6770Oncology social worker ........................................................(608) 756-6871Outpatient transfusion/infusion (Treatment Coordination Center) ....(608) 756-6601Pastoral care .......................................................................(608) 756-6000Radiation oncology .....................................(608) 756-6500/(800) 261-6565Surgical oncology ................................................................(608) 756-7277Urology ..............................................................................(608) 741-6990

Mercy Pain Center..................................................................(608) 756-6049

Front: Janice Johnson, RN; Martha Roberts; Shahid Shekhani, MD. Standing: Emily Robinson, MD; Tricia Obrecht, CTR; Karol Huenerberg, APNP, CN;B.K. Wasiljew, MD; Keith Konkol, MD; Patricia Garner, MD; Rev. Doug Dowling;Michelle Leverence.

Not shown: Tani Abendroth; Linda Brethauer, APNP, AOCN; Jan Botts, RN; Amy Carey; Shawn Davenport, PT; Gregory Denison, MD; Ronald Garcia, MD; Thomas Haas, DO; Nedra Hanson, RHIT; Rachel Hill Smith; Don Janczak, PharmD; Erik Hollander; Carol Johnson, RN; Francis Kaveggia, MD; Masood Khan, MD;Meridyth Munns, MD; Gary Peplinski, MD; Douglas Puffer, MD; James Richardson, MD; Sue Ripsch, VP.

To serve its patients better, the hematology and medicaloncology departments of theMercy Regional Cancer Centerhave relocated to a more spacious and comfortable area on the Mercy Campus in Janesville.

Hematology and medicaloncology are now locatedwithin the Mercy Michael Berry Clinic, on the secondfloor of the new Sister MichaelBerry Building. For patients’convenience, the buildingoffers two floors of indoor parking and a skywalk toMercy West Clinic and MercyHospital and Trauma Center.

The new area offers a CancerResource Center, more state-of-the-art chemotherapy stationswith a bird’s-eye view of theRock River, and an on-site laboratory.

Our new medical oncology and hematology unit hasbeen expanded to 16 chemotherapy treatment bays and creates a calm, relaxing environment for our patients. Each state-of-the-art bay provides a scenic view overlooking the Rock River.

5 A new view for patients

Our new skywalk connects the Mercy Michael Berry Clinic, Mercy West Clinic and the Mercy Hospital and Trauma Center with a two-story indoor parking plaza.

Mercy Campus Skywalk

7 Mercy Cancer Registry report

The Cancer Registry of the Mercy CancerProgram provides data management services to comply with mandatory state cancer reportingregulations, as well as the data needs of clini-cians, administrators and other qualified users. In addition, the registry also provides data tonational-level cancer surveillance organizations for incidence measurement and epidemiologicalstudies. Since its inception in 1994, the registryhas collected data on more than 9,200 cancerpatients, with 675 new cases entered for the calendar year 2009, the last complete year ofdata collection.

The local registry database contains demographicand clinical information from diagnosis throughtreatment, as well as annual lifetime follow-updata. The follow-up process, in addition to providing critical information about disease statusand treatment outcomes, also performs a valuableservice for physicians and patients by remindingthem that regular reassessment of the disease isvital for early detection of recurrences or subse-quent primaries. Currently, the registry is activelyfollowing more than 4,500 living patients.

Patient volume by class of case Figure 1 shows the variability in the total numberof cancer cases reported since the registry’sinception in 1994. The incidence for 2009 was675 cancer cases, up approximately 5 % from2008. Ninety-four percent of these cases (632)were newly diagnosed and/or received the firstcourse of treatment within Mercy Health System.These are designated as “analytic” cases and all further analyses are restricted to these data.

Age distributionThe median age at diagnosis for cancer of allsites was 66 years of age according to the SEER National Database from 2003-2007.Approximately 1% were diagnosed under the age of 20; 3% between 20 and 34; 6%between 35 and 44; 14% between 45 and 54; 22% between 55 and 64; 25% between 65 and 74; 22% between 75 and 84; and 8% at 85+ years of age.

Trends in Cancer Incidence by Year

1995 1999 2001 2003 2005 2007 20090

100

200

300

400

500

600

700

800

1997

Mercy Health System

Year

Analytic Non-Analytic

Num

ber o

f Cas

es

Figure 1

Mercy Cancer Registry report, continued

0

20

40

60

80

100 Age at Diagnosis - Females

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

2005 2006 2007 2008 2009

90+

0

20

40

60

80

100 Age at Diagnosis - Males

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

2005 2006 2007 2008 2009

90+

The age range for females diagnosed at MercyHospital Janesville between 2005 and 2009was 15-101 years of age with a median age of63. Eighty percent of all females were diagnosedat age 50 and older. The median age of malesdiagnosed at Mercy in the same timeframe was64, with the ages ranging from 10-98 years of age. Eighty-eight percent of all males werediagnosed at age 50 or greater. The age distribution compares quite similarly with nationalstatistics, with 84% of all our patients diagnosedwith cancer in their 50s or older.

HOW THE MERCY CANCER

REGISTRY BENEFITS OUR PATIENTS

Our concern for our patients with cancer

continues long after they leave treatment.

That’s why each person who is diagnosed

with cancer at Mercy Health System

becomes part of the Mercy Cancer Registry.

Our primary responsibility is to provide

lifetime follow-up on all registry patients,

and either the patient or his physician

will be contacted at least annually to see

how the patient is doing. At all times, strict

confidentiality is maintained. Maintaining

regular contact helps us follow our patients’

treatment, if any, and identify new or

recurring physical problems they might

have. It also helps us assess the need for

future cancer programs.

It is important that we are able to maintain

contact with all our past cancer patients.

Patients who move or change their phone

number are asked to call the Mercy Cancer

Registry at (608) 756-6139.

8

9 Mercy Cancer Registry report, continued

Probability of developing cancerThe lifetime probability (or risk) of developing ordying from cancer refers to the chance a personhas, over the course of his or her lifetime (frombirth to death), of being diagnosed with or dyingfrom cancer. These risk estimates, like annual incidence and mortality data, provide anothermeasure of how widespread cancer is.

These numbers are average risks for the overallU.S. population. The probability of being diag-nosed with an invasive cancer is higher for men(44%) than for women (38%). However, becauseof the earlier median age of diagnosis for breast

cancer compared with other major cancers,women have a slightly higher probability of developing cancer before age 60 years.

An individual’s risk may be higher or lower thanthese numbers, depending on their particular riskfactors; e.g., differences in exposure and/orgenetic susceptibility. While only approximately 5% of all cancers are hereditary, all cancers are a result of malfunction in the genes that control cell growth and division. This table demonstratesthe lifetime probability of developing the most frequent diagnosed cancers.

Probability of Developing Invasive Cancers Over Selected Age Intervals by Sex, US, 2004-2006*American Cancer Society - Facts and Figures 2010

Birth to 39 (%)

40 to 59 (%) 60 to 69 (%)70 and older (%)

Birth toDeath (%)

All sitesMaleFemale

1 in 701 in 48

1 in 121 in 11

1 in 61 in 10

1 in 31 in 4

1 in 21 in 3

Urinary bladderMaleFemale

1 in 4,7411 in 10,613

1 in 2571 in 815

1 in 1061 in 385

1 in 271 in 99

1 in 261 in 84

Breast Female 1 in 206 1 in 27 1 in 29 1 in 15 1 in 8

Colon and rectumMaleFemale

1 in 1,2961 in 1,300

1 in 1101 in 139

1 in 671 in 94

1 in 221 in 24

1 in 191 in 20

LeukemiaMaleFemale

1 in 6031 in 798

1 in 4751 in 690

1 in 2991 in 504

1 in 841 in 128

1 in 661 in 92

Lung and bronchusMaleFemale

1 in 3,4611 in 3,066

1 in 1051 in 126

1 in 431 in 57

1 in 151 in 21

1 in 131 in 16

Melanoma of skinMaleFemale

1 in 6381 in 360

1 in 1551 in 183

1 in 1381 in 274

1 in 561 in 126

1 in 371 in 56

Non-Hodgkin lymphoma (NHL)

MaleFemale

1 in 7821 in 1,172

1 in 2251 in 315

1 in 1711 in 227

1 in 581 in 72

1 in 441 in 52

Prostate Male 1 in 9,422 1 in 41 1 in 16 1 in 8 1 in 6

Uterine cervix Female 1 in 648 1 in 374 1 in 755 1 in 552 1 in 145

Uterine corpus Female 1 in 1,453 1 in 136 1 in 121 1 in 81 1 in 40

10Mercy Cancer Registry report, continued

Primary sitesThe distribution of the most preva-lent cancers seen at MHS haschanged very little over the lastdecade. The top seven cancer sites account for more than 62% of all newly diagnosed cancersseen at MHS. Comparable to the national data, the most common sites seen include breast,prostate, lung and colorectal cancers. In 2009, MHS saw a significant increase in the number of new melanoma cancers treated(greater than 50% from 2008). This can be attributed to the continuous efforts of skin cancerscreenings, patient education andawareness programs. In addition,the number of newly diagnosed colorectal cancers continues todecline as more patients are routinely screened.

0

20

40

60

80

100

120 Most Common Analytic Sites

Breast Prostate Lung Colorectal Bladder Melanoma Hematopoietic

2005 2006 2007 2008 2009

The most frequent cancer sites in women at MHS were breast, lung and colorectal. In men, themost frequent sites were prostate, lung and colorectal cancers. Compared with national data,our incidence of prostate is somewhat lower with the incidence rates being comparable forboth lung and colorectal cancers and somewhat higher for melanomas of the skin. Our inci-dence of breast and colorectal cancers was somewhat lower when compared to the nationalaverage with the incidence of lung cancers being comparable. Higher and lower incidencerates may be due to our wide range of screening, diagnostic and treatment services.

Male Incidence ComparisonNat’l MHS

Prostate 28% 20%Lung 15% 13%Colorectal 9% 10%Melanoma 5% 9%Bladder 7% 8%Kidney 4% 3%NHL 4% 6%All Others 28% 31%

Female Incidence ComparisonMHS Nat’l

Breast 25% 28%Lung 14% 14%Colorectal 5% 10%Melanoma 6% 4%Uterine 6% 6%Thyroid 2% 5%Ovary 1% 3%All others 41% 30%

11 Mercy Cancer Registry report, continued

Mercy Hospital and Trauma Center’s hospitalist program

Majed Al-Hamwi, MD Hospitalist, Board certified internal medicineJuan Hernandez, MD Hospitalist, Board certified family medicineMasood Ali Khan, MD Hospitalist, Board certified internal medicine

Balvindar S. Sareen, MD, MBA Hospitalist Medical Director, Board certified internal medicineSyed-Saleem Shamsee, MD Hospitalist, Board certified family medicine

Javed Sheikh, MD Hospitalist, Board certified internal medicineGabriel Szekely, MD Hospitalist, Board certified family medicine

Stage at diagnosisStaging describes the extent or severity of anindividual’s cancer based on the extent of theoriginal (primary) tumor and the level of spreadin the body. Knowing the stage of the diseasehelps the physician plan a patient’s treatmentand estimate prognosis. Cancers with the samestage usually have comparable outlooks and areoften treated similarly.

For most cancers, the stage is based on threemain factors:• T – the original (primary) tumor’s size and/orextent of the tumor into regional tissues

• N – whether or not the cancer has spread to nearby lymph nodes

• M – whether or not the cancer has spread to distant areas of the body

Once the T, N and M are determined, a stagegroup of I, II, III or IV is assigned, with a stage Ibeing early and stage IV being advanced.

Thirty-two percent of all patients diagnosed withcancer during 2005-2009 were staged in theearliest stages. This compares similarly with the

national database of 30%. Sixty-eight percent of all patients had a stage III or earlier cancer.Again, this compares favorably with the nationaldata at 65%. Mercy’s continual goal is toincrease the number of patients diagnosed with an earlier, more treatable stage. We do this with continued public awareness and patient education programs, screening and prevention programs and earlier detection.

AJCC Stage at DiagnosisAll 2004-2008 Analytic Cases

Unknown1%NA

14%

Stage 417%

Stage 314%

Stage 222%

Stage 125%

In Situ7%

Mercy’s cancer team works closely with hospitalists at Mercy Hospital and Trauma Centerto offer the best care for our cancer patients during their hospital stays. Mercy hospitalistsare on-site 24/7 and are ready to see patients as soon as they are admitted to MercyHospital and Trauma Center. Mercy hospitalists are available for evaluations, treatmentsand consultations, and they communicate with the patient’s primary physician.

12Tumor Board conferencesTumor Board conferences are held with the inten-tion of providing a multidisciplinary, consultativeforum to openly discuss, plan and educate on thediagnosis, treatment and appropriate follow-up ofcancer patients at MercyHealth System. Physicianssubmit current cases to registry staff the week priorto the conference. Patientselection is often determinedby criteria such as: casesthat are prospective, interest-ing or challenging. A briefclinical presentation and a synopsis of diagnostic and pathologic studies areprepared. The moderatorsencourage a consultativeapproach regarding recommended surgical andtherapeutic options alongwith providing educationalinformation concerning staging, innovative therapies,as well as additional variousrelated topics. Following thepresentation of all pertinentinformation, discussionregarding further recommen-dations is encouraged.

In March 2009, a multi-disciplinary Breast CaseConference was initiated to enhance the coopera-tive care of the breast cancer patients at MercyHealth System. Much like Tumor Board, the intenthas been to create a consultative environmentconducive to planning the best possible course forthese patients. Each conference includes breastcancer cases diagnosed at Mercy Health Systemfrom the previous month. In 2009, 38 breastcases were presented at Breast Conference.

Periodically, educational speakers with informativeforums on a range of cancer-related subjects are

featured. In cooperation with the ContinuingMedical Education office, seven didactic presentations were given in 2009:

Tumor Board conference is held on the first, third and fifth Thursday of each month. BreastConference is held the second Thursday of eachmonth. Attendees include physicians, residents,nurses, medical students and other allied healthprofessionals. Educational value is available to those who attend. For more information regarding Breast Conference or Tumor Board, or to inquire about having a case presented,please contact Martha Roberts in the CancerRegistry at (608) 756-6107.

Colon/Rectum 13Lung 11Lymphoma 10Breast (not including Breast Conference) 6

Thyroid 4Melanoma 3Soft tissue 3Unknown primary 3Anal canal 2Brain 2Bladder 1Esophagus 1Gallbladder 1Larynx 1Liver 1Ovary 1Parotid 1Benign 2

Total 66

TUMOR BOARD SITES DISCUSSED

1. “Case Studies in Chronic Pain:A Multi-Modal Approach,” Dr. Vikram Patel

2. “Palliative Medicine: AnOverview,” Dr. Dena Green

3. “Society of Thoracic SurgeonsNational Surgical Database:Paradigm for OutcomeReporting,” Dr. Kenneth Wolnak

4. “A New Era of MinimallyInvasive Surgery at MercyHospital: Multi-SpecialtyImplementation of the daVinciSi Robotic Platform,” Dr. Nick Gianitsos

5. “Targeted Therapies in LungCancer,” Dr. Toby Campbell,University of Wisconsin

6. “Update on the Evaluation of Hematuria,” Dr. A. Vishnu Moorthy,University of Wisconsin

7. “Cancer ScreeningGuidelines,” Dr. Shahid Shekhani

13

Although kidneycancer is primarilya surgical disease,its diagnosis mayinvolve severalmedical special-ties because thesecancers havemany presenting

signs and symptoms. In fact, its initial diagnosis is often made incidentally during abdominal ultrasound, CAT scan, or MRI imaging performedfor other reasons.

The incidence of kidney cancer has risen over the past 20 years and represents about 2-4% ofall cancers. These tumors account for 38,000cases annually and approximately 13,000 cancer-related deaths. Thirty percent of patientshave metastatic kidney cancer. The female tomale ratio is approximately 2:1 and is most common in patients between the fifth and seventhdecades of life. The incidence is highest inScandinavia and lowest in Asia. It is more com-mon in urban settings. Although most cases aresporadic, occasionally kidney cancer is associatedwith von Hippel-Lindau disease, tuberous sclerosiscomplex or other rare syndromes.

The etiology of kidney cancer or renal cell carcinoma is unknown, however, several interesting associations have been found. There is a positive correlation between the incidence of renal carcinoma and a high consumption offats, oils, milk and sugar. Obesity is also a riskfactor. The strongest risk factor for developing

kidney cancer is tobacco use, with a twofoldincreased relative risk.

Administration of estrogens in hamsters has beennoted to produce renal carcinoma. Approximately20 years ago, it was recognized that patientswith renal failure who are undergoing hemodi-alyasis or peritoneal dialysis have increased risk for developing multiple kidney cysts and occasional kidney cancer.

Mercy’s Tumor Registry provided data for MercyHospital and Trauma Center and comparisondata from the Nation Cancer Database (NCDB)for years 1994-2009. Overall, the frequency of kidney tumors has been slowly but steadilyincreasing. During these 16 years, we treatedover 200 patients with kidney cancer.

The majority of kidney cancers are now found as asymptomatic incidental masses on imagingstudies obtained for another purpose. The classical triad of hematuria, flank pain and a palpable mass is found in approximately 11% ofpatients. General symptoms such as weight loss,fever, anemia and night sweats are common.Paraneoplastic syndromes can also occur with kidney cancer with hypercalcemia, abnormal liver function test evaluation, or amyloidosis.

Ninety percent of kidney tumors are comprised of renal cell carcinoma, with benign tumors suchas oncocytoma and angiomyolipoma being lessfrequent. Other rare pathologic types of kidneytumor include sarcoma, hemangiopercytoma, lymphoma, and occasionally, tumors that metasta-sized from other sites.

Francis F. Kaveggia, MD, FACS

Department of Urologic Surgery

Mercy Health System

Kidney cancer at Mercy Hospital and Trauma Center: 1994-2009

14Kidney cancer, continued

Renal neoplasms are highly resistant to nonsurgi-cal forms of therapy such as chemotherapy, radiation therapy, hormonal manipulation andimmunotherapy. In the past few years, sunitiniband sorafenib have shown response in selectedpatients. Radical nephrectomy is the gold standard treatment for localized renal cell carcinoma with a normal contralateral kidney.Nephron-sparing surgery has also become morepopular with absolute indications including solitary kidney, bilateral kidney tumors, and pre-existing chronic renal insufficiency.Laparoscopic and robotic-assisted surgery—eitherradical nephrectomy or partial nehrectomy—have become newer modalities of minimally invasive treatment. Renal artery emobolization or angioinfarction can be used to shrink the largehypervascular tumors before surgery, and to control bleeding as well as pain in symptomaticpatients with inoperable renal cell carcinoma.Occasionally, tumor involvement of the vena cavacan pose technical challenges.

Carcinoma of the renal pelvis and uterer accountfor 5% of urothelial neoplasms. The vast majorityof these tumors are transitional cell carcinomawith etiologies similar to those of transitional cell

Stage Distribution - Kidney and Renal Pelvis Cancers

Stage I Stage II Stage III Stage IV

MHS NCDB

01020304050607080

9%10%

48%

63%

2%0%

16%16%13%10%

Stage 0

11%

1%

Unknown5

10

15

20

25

30

1995 1999 2001 2003 2005 2007 20091997

Volume of Analytic Kidney and Renal Pelvis Cases by YearMercy Health System

Year

Num

ber o

f Cas

es

Gender Distribution - Kidney and Renal Pelvis CancersMHS NCDB

01020304050607080

38%44%

62%56%

Male Female

Age Distribution - Kidney and Renal Pelvis Cancers

Pediatric 20-29 30-39 40-490

5

10

15

20

25

30

35

50-59

MHS NCDB

60-69 70-79 80-89 90+

15 Kidney cancer, continued

carcinoma of the bladder. Persons whoconsume large quantities of analgesicscontaining either aspirin or phenacitinhave a nine-fold greater risk of developingtransitional cell cancer of the renal pelvis.Balkan nephropathy, an environmentalinterstitial kidney disease of unknowncause, is also a risk factor. Certain occupational exposures to solvents alsowill pose a risk factor for carcinoma of the renal pelvis and ureter. Renal pelvictumors and tumors of the upper ureter arebest treated by radical nephrouretecomywhere the kidney, adrenal, ureter, and acuff of bladder is removed. The overallfive-year survival rate following this type of surgery is 84%.

Percutaneous biopsy of kidney tumors is usually not recommended due to thehigh incidence of false negative biopsies.Kidney tumor biopsy may be indicatedwhen lymphoma is suspected, for patientswith a history of another primary malignancy to rule out metastatic disease,and for complex cysts for cytologic examination.

Tumor stage is the most important predictorof prognosis. Disease-specific survival afterradical nephrectomy for five to 10 yearsfor stage I disease are 90% and 85%respectively. For stage II disease, the five- to 10-year survival rates are 80% and 70% respectively. The phenomenon ofspontaneous tumor regression is extremelyrare and estimated at less than 1%.Metastatic disease most commonly goes to the lung, followed by lymph nodes,liver, bone and adrenal gland.

5-year Survival Rates for Kidney and Renal Pelvis Cancers

Stage 1 Stage 2 Stage 3 Stage 4

MHS NCDB

1998-2002

0

2020

4040

6060

8080

100100

75%

63%

82%72%74%

NA9%10%

56%

29%

Stage 0

First Course Treatment for Kidney and Renal Pelvis Cancers

Stage 1 Stage 2 Stage 3 Stage 4

MHS NCDB

01020304050607080

19%18%

8%3%

73%79%

Stage 0

16American Cancer Society

Having cancer is hard. Finding help shouldn’t be.No matter what you need, the American Cancer Society can help.

• Easy-to-understand information to help you make decision about your care

• Referral for day-to-day questions such as financial, insurance, transportation and lodging

• Connection to others who have been there for emotional support

Information• 24-hour free phone help: (800) 227-2345• On the Internet: www.cancer.org• Advice on clinical trials• Tools to help with your treatment

Day-to-day help• Help finding transportation and lodging• Help with prescription questions• Help with financial and insurance questions

Emotional support• Help finding local support groups• Cancer education classes• An online community for cancer survivors

and their families

American Cancer Society Cancer Resource Network offerings:

The American Cancer Society is able to provide support to cancer patientsthrough its fundraising efforts. Eventssuch as Daffodil Days, Walk/Run, and Relay for Life,supply the necessary funding to continue the missionof the American Cancer Society.

Mercy Health System is proud to continue to be partners with the American Cancer Society, throughsponsorships and support services. In 2010, theAmerican Cancer Society raised more than $89,000in the Janesville area, with the assistance of MercyHealth System participants.

American Cancer SocietyCancer Resource Network goals• Reach more newly diagnosed

patients, with a focus on the

medically underserved

• Deliver timely information and

support programs

• Promote informed decision-making

• Enhance quality of life for cancer

patients, survivors and caregivers

• Enhance our relationships with

patients, survivors and caregivers

• Allow for a coordinated approach to

promote ACS programs and services

Dr. Shahid Shekhanispeaks to walkers/runnersat the American CancerSociety’s JanesvilleRun/Walk, in June 2010

17 Radiofrequency ablation of renal cell carcinoma

Radiofrequencyablation is a new,minimally invasivealternative to surgery for thetreatment for renalcell carcinoma.With this technique, a

specialized, needle-like probe is placed into thetumor under CT scan or ultrasound guidance, and radiofrequency energy is applied. Theradiofrequency energy generates heat that kills the cancer cells.

Ablation is quite precise, so there is minimal to no damage to the kidney itself, thus preservingkidney function. For optimum patient comfort andsafety, the procedure is usually performed undergeneral anesthesia, although it can potentially be performed under conscious sedation. Patientswhose health might not permit a more invasivesurgery are the ideal candidates for radiofrequencyablation.

Advantages of the procedure include shorter pro-cedure time, very little post-procedure discomfort,and minimal recovery time—most patients gohome the following morning. Radiofrequencyablation is particularly effective for tumors smallerthan 3.5 cm. Five-year, disease-free, survival inpatients with these small tumors is comparable to more invasive surgery, and if the tumor doesrecur, it can be safely re-ablated.

Radiofreqency ablation of renal cell carcinoma isperformed in the interventional radiology depart-ment at Mercy Hospital and Trauma Center. Formore information, call (608) 756-3005.

1. Zagoria RJ, Traver MA, Werle DM, Perini M,Hayasaka S, Clark PE.Oncologic Efficacy of CT-Guided PercutaneousRadiofrequency Ablation of Renal Cell Carcinomas. Am. J. Roentgenol., Aug 2007; 189: 429-436.

2. Tracy CR, Raman JD, Donnally C, Trimmer CK,Cadeddu JA. Durable oncologic outcomes after radiofrequency ablation: experience from treating 243 small renal masses over 7.5 years. Cancer. 2010 Jul 1;116(13):3135-42.

Gregory L. Denison, MD

Department of Interventional Radiology

18

Since 1994, the Mercy Hospice Care teamhas been committed to ensuring that every terminally ill person we serve lives out his or her remaining days in comfort. MercyHospice Care provides a special team-oriented concept of care to provide comfortand support to clients and their families whena life-limiting illness no longer responds tocure-oriented care. Members of the hospicecare team include the:

• Patient• Family members• Hospice medical director• Patient’s primary care physician• Registered nurses• Social workers• Spiritual counselors• Bereavement counselors• Volunteers • Hospice aides and others

Mercy Hospice Care offers comfort (palliative) care and hospice home care services for patients with life-limiting conditions. The hospice care team addresses all symptoms ofdisease with a special emphasis on controlling a patient’s pain and discomfort and the emotional,social and spiritual impact of thedisease on the patient and theirfamily members.

In addition, specially trained Mercy Home Health Care staff,including nurses and aides, provides comfort care to patientswith chronic or life-threatening conditions including heart, respiratory, neurological andorthopaedic diseases or cancer. These patients may continue to receive treatment, including chemotherapy, and other cure-oriented services.

For more information, please call (608) 755-6920 or toll-free (800) 369-2201.

Mercy Hospice Care: offering comfort, support and caring

MercyAssistedCare.org

19 Mercy Palliative Care Program

Since January 5,2009, MercyHospital andTrauma Centerhas had an activein-hospital palliative careconsultative service.

The World Health Organization has succinctlystated that, “palliative care affirms life andregards dying as a normal process, neither hastens nor postpones death, provides relief frompain and other distressing symptoms, integratesthe psychological and the spiritual aspects ofcare, offers a support system to help patients liveas actively as possible until death, offers a sup-port system to help the family cope during thepatient’s illness and in their own bereavement.” In light of that definition, the Mercy PalliativeCare Program strives to offer a high-quality service for patients, and their families with serious or life-limiting illness who are seeking life-prolonging or curative care, or are nearing the last stages of life.

The Mercy Palliative Care Program accomplishesthese goals by using an interdisciplinary teamapproach. This team includes the patient’s primarycare physicians, medical and nursing specialistsin palliative care, direct care nurses, clergy anddischarge planners. By using the interdisciplinaryteam, patients and their families have the opportu-nity to discuss and plan the complicated goals ofcare, code status, transition to hospice, symptommanagement and their care at the end of life.

Many studies have shown that effective palliativecare can manage fatigue, anxiety, breathlessness,nausea, depression, constipation and other distressful patient symptoms. A recent studydemonstrated patients with advanced lung cancer actually lived longer when they wereinvolved with early palliative care intervention intheir diagnosis when compared to those patientswho were not offered palliative care until later.

Although this report focuses on patients with cancer, the benefits of palliative care can also be used in patients with congestive heart failure,emphysema, AIDS and other serious illnesses.

The Mercy Palliative Care Program strives to coordinate complicated medical decisions throughcommunication and excellent medical care to provide the highest quality of life possible for ourpatients with serious and life-limiting illnesses.

Keith A. Konkol, MDDirector of Mercy Palliative Care Program

20Pathology’s role in cancer treatment

Over time, cancer has become a more commondisease, killing more people every year andbecoming more commonplace. With renal andother cancer rates steadily rising each year, earlydetection has become the best way to stop thespread of cancer, and leading the charge arepathologists around the world.

Imagine you’re in the hospital getting a basiccheckup, but your doctor finds something wrongduring your physical examination. You come back for further testing and a small lump is found.Your doctor will test this area, most likely taking a tissue or fluid sample for further diagnosis. Butdoes the doctor find out what the lump is himself?No, it is sent to the pathology department, wherethe material will be analyzed to determine the disease.

Unsung heroes of the medical world, pathologistsdeal in determining the nature, cause of and ultimate treatment of disease in patients. The vast majority of cancer diagnoses are made orconfirmed by pathologists. While pathologistsdon’t see patients directly, they act as consultantsto other physicians, offering their advice anddiagnoses.

Pathology, by definition, is the study and diagnosis of disease through examination oforgans, tissues, bodily fluids and whole bodies.Using hospital laboratories, pathologists and lab technicians work to tirelessly test samples and diagnose disease through molecular, microscopic and chemical testing, ensuring that no patient leaves without the correct diagnosis and treatment.

The Mercy Health System Pathology Departmentis here for the diagnosis and determination of thedisease. Ensuring that all patients are cared forcorrectly and comfortably is a big part of MercyHealth System’s commitment to the communities itserves, and our pathology department is on thefront lines of stopping disease in its tracks.

21 Mercy Regional Cancer Center:hematology/medical oncology clinic

The hematology/medical oncology clinic of Mercy Regional Cancer Center is located on the second floor of the Sister Michael BerryBuilding on the Mercy Campus, Janesville. Services are also offeredat Mercy Walworth Hospital and Medical Center.

The clinic treats patients with hematology or cancer diagnoses. The care team includes oncologists, a nurse practitioner, registerednurses (83% are oncology certified nurses), medical assistants, a social worker, a patient financial counselor, a dietitian and support personnel, including a receptionist and medical records clerk. All careteam members work together with the common goal of providing quality, compassionate care to the patients who enter through thedoors seeking hematology or oncology services. On-going communi-cation with the patient’s primary care physician, radiation oncologistand/or surgical oncologist is maintained to ensure continuity of care.

Individualized chemotherapy treatments are administered to patientsin the hematology/oncology clinic by specially trained RNs underthe directive of the medical oncologist. Patients receive their treat-ments in a comfortable environment. Chemotherapy treatment plansare individualized based on numerous factors, including cancer typeand stage of disease. Leading-edge chemotherapy treatments areavailable to patients. Supportive treatments for patients are also available in the treatment room, including other intravenous infusions,lab draws and injections.

Our hematology/oncology patients also have the option to participate in clinical trials. Mercy’s hematology/oncology clinic is affiliated with the Eastern Cooperative Oncology Group of theNational Cancer Institute, as well as the Wisconsin OncologyGroup. Chemotherapy treatments for breast cancer, lung cancer and colorectal cancer are just some of the clinical trials available through these affiliations.

The Hematology/Oncology

Clinic of Mercy Health

System exists to provide

patients superior care and

state-of-the-art therapy

for cancer and blood

disorders. The Mercy

Hematology/Oncology

Clinic will achieve a high

level of patient satisfaction

through coordination of

treatment, commitment

to quality, superior patient

care, and an exceptional

degree of caring and

compassion for our

patients and their families.

608•756•6871 800•928•1103

Mercy Regional Cancer Center hematology/oncology clinic

mission statement

22From our partners …

Angela Butters

“I am a 42-year-old mother of a little boy whoturned three in November. I enjoy gardening,cooking and reading books. But what I enjoymost is spending time with my son, whether it is swimming or playing with cars.

“I have been a registered nurse for 14 years andhave worked as an oncology nurse for 12 years.I work in Mercy’s medical oncology departmentas a triage nurse for Dr. Shahid Shekhani.

“I am asked repeatedly why I work in oncologyand how I can handle doing what I do. That isan easy answer. I do it for the patients. Oncologypatients are very special and have special needs.

“I want to be there for them to take care of themin every aspect. Whether they have an emotionalor physical need, I want to be there for them.

“I am proud to be a Mercy partner. I think wehave a great group of people that work here. Ihave my own doctors here for my family and find them to all be very caring people with verycaring staff. I am probably most proud of mydepartment. I feel we are a unique crew thatgoes the extra mile. We are there for our patientsand for each other.

“My patients and my co-workers keep me motivated. My biggest reward is knowing that I do whatever I can on any given day to takecare of whatever my patients need. Sometimes it might be something beyond my control (such asfinancial issues), but just listening or pointing them in some directions for financial help goes a long way. More than anything, patients justwant to know that they are being listened to andthat you care.”

Why I work in oncology ...That is an easy answer. I

do it for the patients.Angela

23 Mercy’s clinical trial program

At the MercyRegional CancerCenter, we continu-ally strive to offercutting-edge treat-ments in a coordi-nated careapproach toensure the best

possible patient experience and provide access tothe latest advances in cancer care, close to home.

When patients with newly diagnosed cancer areseen in the medical oncology clinic, they are oftenconsidered for clinical trials. As members of theEastern Cooperative Oncology Group and theWisconsin Oncology Network, we have severalphase II and phase III trials available for patientswith the most common diagnoses. Our clinical trialprogram opened in 1997, and we currently have18 trials open for accrual in breast cancer, lungcancer, colorectal cancer, multiple myeloma, andchronic lymphocytic leukemia/small lymphocyticlymphoma.

Most of the trials open at Mercy Regional CancerCenter are large, phase III clinical trials comparingpromising new treatments with standard treatments.We also have a few phase II trials that are testingnew treatments in smaller groups of patients todetermine effectiveness. Our patients have recentlyparticipated in trials that led to the FDA approval ofseveral new cancer therapies.

The clinical trial program closely works with theMercy Health System Institutional Review Board(IRB) to make sure the patient’s needs are being

met. The IRB is made up of physicians, communityrepresentatives and clergy. The IRB approves allstudies before they are opened, and monitors the research on a regular basis. The role of the IRBis to protect the rights of research participants andto ensure the safety of the patients participating on trials.

Our research team consists of the patient’s oncolo-gist, the research nurse and data manager, theprincipal investigator, the chemotherapy nurse, andthe oncology nurse practitioner. Each member hasa specific role in making sure patients participatingon research studies are treated according to theprotocol in a safe manner. One advantage of clinical trials is the extra attention patients receivebefore, during and after their treatments.

Clinical trials are an opportunity for patients to benefit from advances in cancer care. Through our community program, many patients are able to receive the newest treatments close to home,without having to travel to a larger city. If there isnot a clinical trial available for patients locally, ourresearch team has access to researchers at nearbymajor universities and cancer centers, and is ableto help interested patients navigate the way toappropriate care.

Emily Robinson, MDDepartment of Medical Oncology Mercy Health System

24clinical trial program, continued

If you’d like more information about

your suitability as a clinical trial

participant, talk to your doctor or

call the Mercy Regional Cancer

Center at (608) 756-6871 or

toll-free (800) 928-1103.

Your cancer clinical research team

Oncologist• Identifies patient for clinical trial• Conducts discussion of risks and benefits• Obtains informed consent• Directs study treatment as outlined by the protocol

• Monitors response and side effects

Research nurse/data manager• Screens patient for eligibility• Monitors treatment plan, response and toxicity

• Collects data to send to study sponsor• Reports adverse events to sponsor and the National Cancer Institute

• Communicates with IRB

Principal investigator• Reviews potential studies for participation• Presents new studies and follow-up reportsto IRB regularly

• Oversees adherence to study protocol• Reviews adverse events in study patients

Oncology social worker/counselor• Meets with all new cancer patients• Provides emotional support before, during and after treatment

• Provides resources for patients as needed

Chemotherapy-certified oncology nurse• Administers study treatment• Monitors side effects

Oncology nurse practitioner• Monitors patients between visits withoncologist

• Assesses for side effects

25 Genetic testing for hereditary cancer syndromes

Genetic informa-tion and testing isa part of cancercare. Thosepatients who arediagnosed withbreast, ovarian,colon and/or otherspecific cancers

before the age of 50, or have a strong family history of those cancers, are recommended toreceive personalized information and counselingfor hereditary cancer syndromes.

Some families have a gene mutation that can bepassed on from parent to child, causing increasedrisk for particular cancers. At Mercy, we providecounseling and assistance with testing for hereditarybreast/ovarian cancer syndrome and hereditarycolon cancer.

Most patients tested will not have the gene muta-tion. Less than 10% of patients tested are found tohave the gene mutation that increases the risk ofcancer. Patients who have the gene mutation areoffered treatment options that significantlydecrease their risk of cancer.

Family members may also undergo testing. If thereis a gene mutation in the family, each person hasa 50% chance of inheriting it. Genetic testing isrecommended when certain risk factors or “redflags” are present.

These include: • Diagnosed breast, colon, intestinal or uterinecancer before the age of 50, or ovarian cancerat any age.

• Three successive generations of a combinationof these cancers in a family, with one persondiagnosed before age 50.

Genetic testing can be a valuable tool fordecreasing the risk of cancer in families with these gene mutations, and for decreasing anxietyin individuals without the gene mutation.

If you or your family have any of the red flags forrisk of having hereditary colon cancer syndrome,or hereditary breast/ovarian cancer syndrome,talk to your doctor about your concern and forreferral.

Linda Brethauer, APNP, AOCNDepartment of Medical Oncology Mercy Health System

Sharon KruegerLymphocytic leukemia survivor

“From the time of my diagnosis with chronic lymphocytic leukemia during the summer of2008, the Mercy Health System staff worked as a team to provide excellent care.

“My team consisted of:Dr. Jane Anderson – primary care physicianDr. B.K. Wasiljew – surgeonDr. Alan Muraki – radiologist Dr. Emily Robinson – oncologist Rev. Doug Dowling – chaplain

“Each member provided his or her expertise inpreparing me for the months of treatment that I faced.

“I cannot imagine anyone having better cancer treatment than I have had at Mercy, and with integrated, state-of-the art treatment. Dr. Robinson and her outstanding team of nurses and health professionals provided everything I needed to be able to continueworking and managing my day-to-day activities throughout my treatments.

“No one wants a cancer diagnosis, but my journey to remission was made easier by theMercy Regional Cancer Center, and the team ofprofessionals that brought me back to enjoyingeach day. I am thankful for having had excellentcancer care at Mercy Health System.”

I cannot imagine anyone having better cancer

treatment than I havehad at Mercy.

Sharon

26What our patients say ...

27 Mercy Regional Cancer Center:radiation oncology

Mercy Regional Cancer Center’s radiation oncology department is located adjacent to MercyHospital and Trauma Center and Mercy West Clinic . Patients receiving radiation therapy haveeasy access to many services.

Radiation therapy is performed by multiple members of the care team. Team members includethe radiation oncologist, a nurse practitioner, a medical physicist, dosimetrists, radiation therapists, plus a registered nurse, social worker, patient financial counselor and dietitian.Support services are provided by the receptionist and cancer registry staff. The care teamcarefully coordinates the therapy to be administered to the patient, assuring quality care. On-going communication is maintained with the patient’s primary care physician, and referringspecialty physician such as the urologist, gynecologist, otolaryngologist, medical oncologist,and/or surgical oncologist to ensure continuity of care.

State-of-the-art radiation treatment options are available at the Mercy Regional Cancer Center. These options include external beam radiation therapy, intensity modulated radiationtherapy (IMRT), image-guided radiation therapy (IGRT), high-dose radiation therapy (HDR) and Mammosite®.

Radiation treatments are individualized based on numerous factors including cancer type,stage of disease and site to be treated. The goal of all therapy is to deliver a high dose of radiation directly to the tumor while minimizing damage to surrounding healthy tissue. The Mercy Regional Cancer Center uses the PRIMATOM™ treatment system to deliver its radiation treatments.

Patients receiving radiation therapy at the Mercy Regional Cancer Center also have the option to participate in clinical trials through an affiliation with the Radiation TherapyOncology Group.

608•756•6500 800•261•6565

From our partners ...

Bonnie Anderson EichstedtReceptionist

“Growing up, I always knew I would have ajob that would help people. I graduated fromcollege in 1980 with a Bachelor of Sciencedegree in recreation. I became a travelagent, but my husband’s job relocatedme to Janesville. I needed a job.

“I am so grateful thatMercy Health Systemhired me as part of itsfamily in April 1990. Iwas an admitting clerkand then went on tobecome a receptionistat Mercy Clinic South when the family medicineresidency program began. I was asked by aMercy partner if I would like to work at theCancer Center as their receptionist. I told her I didn’t know anything about cancer, but she reassured me that it wasn’t necessary. She saidthat with my people skills and personality, thiswould be the job for me.

“I am so glad that I applied for this job andwas hired in August 1995. It has been 15years since I started and the years have flownby. I do not consider the receptionist job a ‘job.’It’s fun, rewarding, and I meet wonderful peopleevery day. I can help them forget about their illness through humor and conversation. I deco-rate the department to keep it festive and bringin my flowers to keep it cheerful. Many of thepatients I have met return to say ‘hi’ or enjoy acookie on our Wednesday cookie days, eventhough their treatment was 10 years ago.

“I have many duties: answering phones, check-ing in patients, making up charts, requestingmedical records, taking co-pays, etc. Thesekeep me busy between greeting my new friendsas they enter the clinic for their new consults,return for their follow-up appointments, or just

come in for theirdaily treatment. Each and everypatient needs a little tender lovingcare every day.

“I treat each patient,as well as my Mercypartners, as I wouldlike to be treated. Ifeel that smiling isthe simplest thing Ican do to makesomeone feel better,even if the day is

not going the way we want it to.

“This is my home away from home. I look forward to coming to work every day.”

28

Growing up, I always knew

I would have a jobthat would

help people.Bonnie

29 Mercy Regional Cancer Center:surgical oncology

Patients whose cancer treatment regimen requires

surgery look to the Mercy Regional Cancer Center’s

surgical oncology department, staffed by board

certified surgeons and support professionals with

years of experience. Our surgeons’ offices are

located at the Terrace Building, just across the

parking lot from Mercy Hospital and Trauma Center,

where the surgical procedures are performed. The

surgical oncology department employs:

Technologically advanced procedures, including

minimally invasive techniques that use a small scope.

The small incision needed for the scope to enter the body offers the advantages of faster

in-hospital recovery, faster healing, less pain, and minimum risks as compared to traditional

surgical techniques. Screening, surveillance and diagnostic upper and lower gastrointestinal

fiberoptic endoscopy is also provided by the department.

A wide variety of cancer-related surgeries for all stages of

cancer treatment. These include removing cancer that has

spread (metastasized) beyond the original tumor; removing the

majority of malignant tissue (called debulking) in preparation for

chemotherapy; and reconstructive surgeries that help patients

look and feel their best, leading to emotional healing.

Continuous multidisciplinary review of individual cases,

through pathways such as the Tumor Board and the Mercy

Cancer Registry. In this way, the surgical oncologists review

and implement quality controls, provide and receive ongoing

physician education, and evaluate existing technology

to guarantee our patients receive quality care that’s held

to the highest standards.

608•756•7277

From our partners ... 30

Phyllis Garner

“I’m motivated by my ability to make a differencefor my patients.

“I have been a Mercy partner for 18 years, andmy nursing career spans 40 years. I feel privilegedto be spending the last years before my retirementat Mercy.

“The great satisfaction I get from making a true difference in someone's life gets me to the jobevery day. While I have been with Mercy, I have always worked in the surgery department,working with Dr. Wasiljew for 17 years.

“The word teamwork applies across the board, and our department staff truly expresses Mercy’smission.

“Every day, I deal with patients who are scared of the unknown. With just a few words—’you havecancer’—their life has changed. It is my job

to comfort them with a smile or words, and Ibecome their guide through the many appointmentsand questions, offering them a shoulder to cry on.

“Recently, one of my patients stopped by and shewas crying because her phone had been turnedoff, since she needed to use her money to makethe house payment. She did not know what time to be at the hospital the next day for surgery. Icalled the job center and was able to help herreceive emergency financial assistance. I like thatmy patients feel they can count on me to help them when they have a need—no matter what type of need arises.

“It gives me great satisfaction to be stopped and told, ‘You truly made a difference when I was scared.’

“Every Mercy partner has one agenda and that is to help the patient at one of his or her most vulnerable times. What we as health careproviders need to remember is that an extra smile, kind word or just a listening ear, can make all the difference for our patients.”

I’m motivated by my ability to make a

difference for my patients.Phyllis

From our partners ...31

Heidi Canfield, CMA

“My name is Heidi Canfield, and I've been a certified medical assistant for 14 years. I am also a licensed esthetician and a certified professionalcoder. I work in the general surgery department at Mercy Terrace as a medical assistant. I live inSouth Beloit with my husband, Chris, and my feistyfeline, Petee.

“While job hunting for a position as a medicalesthetician, I learned about Mercy Health System.

I was impressed with Mercy’s many multi-specialtyclinics and hospitals in Wisconsin and Illinois, andmy original intention was to work for the MercyRegional Plastic Surgery, Skin & Laser Center.

“To get my foot in the door, I accepted a positionas a medical assistant in the general surgery department and have decided to stay! I’m gratefulfor the opportunity to work with four meticulouslyskilled and reputable surgeons.

“Along with assisting the surgeons in taking care of the physical needs of our patients, my main goalis to instill quality assurance. Every patient I meet is greeted with a warm smile, kind words of compassion, and occasional hugs when needed. I am the first person the patient sees before meetingthe surgeon. I strive to ease their fear and anxiety of surgery, and assure them they are in good hands.

“Last fall I had the pleasure of meeting a patientwho had just been diagnosed with breast cancer.On her initial visit, she was sporting a Boston RedSox jersey, a baseball hat and carrying a baseballbat. She informed me that her bat and attire symbolizes her fight against breast cancer. Hermotto is ‘I'm gonna knock this outta the park.’ This woman is amazing. Her positive attitude, determination and inner strength are contagious.

“Being a baseball fan myself, I put a call into a friend who works for the Louisville SluggerCompany. That friend sent me a regulation-size,pink, Susan G. Komen Foundation bat, personallyengraved with the patient’s name.

“Unannounced to the patient at her next post-opera-tive visit, I presented her with the pink bat. She was flabbergasted and could not find words tothank me enough, but the look of joy on her facewas all the thanks I needed. The pink bat now displays signatures of Mercy partners who havebeen involved in her care throughout her journey.

“As health care professionals, we have the ability to make a difference in this game of life.”

I strive to ease theirfear and anxiety of surgery, and

assure them they are in good hands.

Heidi

32What our patients say ...

Joan BrayerBreast cancer survivor

Joan Brayer was diagnosed with breast cancer atthe tender age of 58. That day, September 24,2009, will forever be etched in her memory. Herbattle with breast cancer and her journey to recovery started with a routine mammogram in early September 2009.

Ms. Brayer, a baseball enthusiast, was told sheneeded to have a repeat mammogram on her right breast and then a stereotactic biopsy.

“It didn’t surprise me,” Ms. Brayer said. “I had a suspicion something was wrong. But you don’t ever think that you’ll ever hear those words.”

Those words, considered fighting words to her,were difficult to digest. But Ms. Brayer was readyfor the battle.

“I’m a sports person. I love baseball. And in baseball if you don’t step up to the base, you’llnever know what would happen. I have alwaysbeen a fighter and this cancer doesn’t know who it’s dealing with.”

Ms. Brayer remained under the medical care andguidance of Dr. Patricia Garner, who stood by herevery step of the way.

“There are not enough adjectives to describe Dr. Garner; she is very professional, gentle, compassionate and honest. I’ll never forget my first visit to see her. She acted like she had all the time in the world for me.”

Ms. Brayer had a mastectomy on her right breastshortly after she was diagnosed with cancer.Several months later, she opted to have a mastectomy on her left breast.

“If you have breast cancer in one breast, thatincreases the chances of getting cancer in the other breast,” she said. “And I told the cancer, ‘I’m not giving you another chance.’”

A year after her diagnosis, Ms. Brayer is healthyand cancer free. She credits her well-being to theearly detection of her cancer and the medical staffat Dr. Garner’s office.

“Each and every visit to Dr. Garner’s office—from the receptionists to the nurses—was super personal. They treat you like you’re the only onethere. It’s like a family. I was very impressed.”

Dr. Garner’s staff also presented Ms. Brayer with apink Louisville Slugger. The bat, which she carriesaround as a symbol of strength and her love for thegame, is a constant reminder of her journey fromcancer patient to cancer survivor.

“Baseball is comparable to life,” Ms. Brayer said.“You can’t get to home unless you go to first, second, and third base. And you never knowwhat’s going to happen in between.”

I have always been a fighterand this cancer doesn’t

know who it’s dealing with.Joan

What our patients say ...33

Coreen SmithBreast cancer survivor

Coreen had just graduated from BlackhawkTechnical College with a certified nurse’s assistantdiploma. But when she discovered a lump on herleft breast, she realized that she was going tohave to get it taken care of as soon as possible.Her plans for searching for a CNA position wereput on hold.

Coreen went to her family doctor and wasreferred to the hospital for a mammogram. Thatsame day, she was sent for an ultrasound andthree days later was given her results. “They told me I had a very aggressive, fast-spreadingcancer, but it was caught in Stage 1.” With thisshock to her system, Coreen changed her plans.Instead of pursuing a career in nursing, she would become a survivor. “I thought that there are so many survivors out there, I will be one of them too.”

She met with Dr. Bud Wasiljew, who did herlumpectomy on April 5. “Dr. Wasiljew did an amazing job, and his nurse, Phyllis, is asweetheart.”

Coreen started her first round of chemotherapyMay 5. “Dr. Emily Robinson sent me for a heartscan to make sure my heart was strong enough tohandle all of the chemo drugs. I was on the lowend of normal, so she decided to not start me ona certain drug. I haven’t had any nausea with myradiation treatments, which has helped.”

Coreen also met with Dr. Bart Schmidt in the radiology department. “The radiology departmenthas been awesome. Dr Schmidt explained theentire procedure to me, and what to expect. Itwas still very painful, but I was prepared for itbecause of him. Mercy did an awesome job.”

Coreen says she can give a lot of advice tosomeone with a similar diagnosis. “Follow yourdoctors’ orders, and don’t be petrified of what isgoing to happen to you. You are going to loseyour hair really quick, but get a short haircut.Who cares if people see you bald? It’s easier to lose two inches of hair than really long hair like I had.”

As of July 2010, Coreen was still undergoingtreatments at the Mercy Regional Cancer Center,and was taking things “one day at a time.”

… there are so many survivors out there,

I will be one of them too.Coreen

34Compassionate care for special concerns

The expert staff at the Mercy RegionalUrology Center knows how uncomfortableand difficult it can be to discuss sexual andurologic health problems. In fact, many people hesitate to seek treatment because of the very private nature of these concerns.

There are two important facts you need toknow. First, these problems are almost alwaystreatable, often with excellent results. Second,we specialize in making you feel at easethroughout diagnosis, treatment and follow-upcare for your personal needs.

The Mercy Regional Urology Center treats allgeneral adult and pediatric urologic concerns.Beyond using the latest technology such aslaser therapy and da Vinci robotic surgery,we also have a number of special treatmentprograms for men and women.

For men –• Treatment for erectile dysfunction• Vasectomy reversal• Treatment for all prostate and bladder problems

• Seed implantation therapy for prostate cancer

• Treatment for cancers of the urinary tract• Treatment for urinary tract infections• Treatment for infertility problems• Therapy for voiding dysfunction• Treatment for kidney and bladder stones• Microwave Laser therapy for enlargedprostate

For women –• Treatment for sexual dysfunction• Treatment for cancers of the urinary tract• Therapy for voiding dysfunction• Infertility problems• Treatment for kidney and bladder stones• Stress incontinence treatment, including• SPARC female sling system

Services offered by the Mercy RegionalUrology Center are located in Janesville andLake Geneva, Wisconsin, and Harvard andWoodstock, Illinois. For more information, callMercy HealthLine at (866) 39-MERCY.

Mercy Institute of Neuroscience35

The central goals of the Neuro-OncologyFocus Group involve tailoring treatment to the individual patient’s needs as wellas facilitating ongoing communicationamong involved practitioners, the primarycare provider, and the patient. Once apatient is referred to the group, a treat-ment team is developed as indicated bythe patient’s initial presentation, and ameeting between the patient and teamis arranged. The first half of the meeting includes discussion of thepatient’s case among the team practitioners and development of a tentative treatment plan based on review of medical records andimaging. The patient and his or her support persons (e.g., family,friends) are invited to the secondhalf of the meeting to meet treat-ment team members, hear the teamdiscuss the diagnosis and treatmentplan, and ask any questions theyhave. Following the meeting, theInstitute’s administrative staff schedulesand informs the patient of initialappointments.

The Institute then continues to coordinatecare among providers and serves as a central resource for the patient regardingany concerns he or she may have as treatment progresses.

In accordance with recommendations fromthe American Cancer Society, efforts aremade to keep the patient informed andactively engaged in his own treatment anddecision-making. The patient receives a folder that includes information about histreatment plan and providers, as well as a personal notebook to document importantinformation during his treatment (e.g., testresults, symptoms, appointment schedules,side effects, questions). Information abouteducation and support resources are alsogiven to the patient by the hematology/oncology clinic.

Practitioners have reported their appreciationof this team-based approach that allowsthem to more easily facilitate coordinated,and thus, higher quality, care for theirpatients, while patients continue to appreci-ate the involvement they have in their carethroughout this interactive treatment process.

608•756•6830 866•901•MINDNeuroscience.MercyHealthSystem.org

The Mercy Institute of Neuroscience is proud to offer personalized, multi-disciplinary care for neuro-oncology patients. Consistent with the Institute’s mission to provide comprehensive, coordinated care for all neurological patients, the Neuro-Oncology Focus Group was developedto ensure that patients with brain or spinal tumors also receive this level of high-quality care.Specialists from a variety of disciplines, including neurosurgery, medical and radiation oncology,neuro-radiology, pathology, pain management, and health and rehabilitation psychology, areinvolved in the group.

Mercy’s new da Vinci Si HD Dual-Console Surgical System provides surgeons with an alternative to traditionallaparoscopic or open surgeries,putting a surgeon’s eyes andhands at the controls of a state-of-the-art robotic platform. The da Vinci system enables Mercysurgeons to perform even the mostcomplex and delicate proceduresthrough very small incisions withunmatched precision.

To a surgeon, da Vinci surgery looksand feels like traditional surgery, but withmore intricate robotic capabilities. Withgreater color magnification and depth offield, the da Vinci Surgical System’shigh-resolution 3-D vision provides surgeons improved clarity and detail oftissue and anatomy—critical factorswhen performing delicate procedures.

Da Vinci’s dual consoles also allow twoMercy surgeons to simultaneouslycollaborate during surgery. This ensuresthat two surgeons—meaning two sets of eyes, hands and skills—are involved in the surgery.

To learn more about the da Vinci, visitdaVinci.MercyHealthSystem.org, or call(877) 922-2350.

©2009 Intuitive Surgical, Inc.

• Reduced complications• Reduced hospital stays • Reduced recovery time• Requires just a few tiny incisions for minimal scarring

• Faster post-surgery recovery (days versus weeks)

• Significantly less pain and less blood loss• Less risk of infection• Faster return to normal activities • Overall increased satisfaction

Benefits to our patients:

Surgeries performed:

36da Vinci Si HD Dual-Console Surgical System

37 support services

American Cancer Society Cancer Resource NetworkOne call puts you in contact with experts trainedto give in-depth information to cancer patients,their families and their caregivers. They’ll put youin touch with community resources, includingthose offered at Mercy Health System, and helpyou deal with the multiple medical, financial, emotional and social concerns of having cancer.See p. 16 for more information. These expertsare available 365 days a year and can bereached at (800) 227-2345.

Mercy Regional Breast CenterBreast cancer is the second leading cause of cancer death in women in the U.S. Regularscreening, including monthly breast self-exams, is vital in order to find and treat breast cancerearly. The Mercy Regional Breast Center nowoffers digital diagnostic and screening mam-mography, plus breast MRI, breast ultrasound,stereotactic breast biopsy, and DEXA bone density testing. For more information, call theCenter at (608) 741-6999.

Especially for breast cancer patientsWhether you’ve had a lumpectomy or a mastec-tomy, Mercy’s certified post-mastectomy fitters atthe new Women’s Boutique at the Mercy HealthMall in Janesville can enhance your quality oflife by helping you find just the right breast formsand bras. They meet with each woman privatelyto assess her needs and suggest products for anatural appearance and all-day comfort. TheWomen’s Boutique carries the top brands in breast forms and bras, and also offers breastform covers, bra extenders, swimwear, lingerie,lymphedema sleeves and pumps, turbans, hats,lotions and product cleansers. For appointmentsand more information, call (608) 755-7989 or toll-free (800) 279-5810.

Community cancer screeningsFor most cancers, finding and treating them earlyare the keys to living a longer life and enjoyinga better quality of life. Early detection is key to winning the war on cancer. Mercy HealthSystem offers periodic cancer screenings—most are free—throughout the year. Call MercyHealthLine at (888) 39-MERCY or visitMercyHealthSystem.org for more informationabout upcoming screenings.

Mercy Complementary Medicine CenterTrue health requires a delicate balance of physical, emotional and spiritual wellness. Whenthat balance goes awry—as it often does withcancer—your health may require several forms ofmedical treatment. That’s where complementarymedicine’s greatest strength lies. As its nameimplies, it is used as a complement to conventionalmedicine, and the two together can offer powerful medicine that can restore health.

Whether you choose acupuncture, chiropractic or massage therapy as a complement to your traditional treatment, you’ll find the experienceand understanding you want at the MercyComplementary Medicine Center, located insidethe Mercy Health Mall, Janesville. While itspractitioners work closely with Mercy’s physi-cians, a physician referral is not required tomake an appointment. For more information, call the Center at (608) 741-6799.

38support services

Help for emotional healingHaving cancer means more than treatment for the disease itself. Some individuals struggle with anxiety, depression and other emotional problemsthat require more than talking with family membersor friends. When life seems overwhelming, the mental health therapists, psychologists and psychiatrists at Mercy Options Behavioral HealthServices are here to listen and help you heal. Forreferral information, please call (800) 341-1450.

Exercise programs:Journey to Health Exercise ProgramThis is an exercise and stress management program designed to help cancer patients combat the effects of cancer treatment andimprove their quality of life. Offered at the Mercy Cardiac Fitness Center at the Mercy Health Mall, Janesville. For complete information,call (608) 755-7996.

Financial counselingMercy’s oncology patient financial counselorassists patients with their concerns about the unex-pected costs of treatment and/or lack of insurance coverage. This includes help deciphering formsand referrals to appropriate community resources.For more information, call (608) 756-6500.

Mercy Health System FoundationSince the late 1800s, Mercy Health System has saved thousands of lives, brought tens of thousands of babies into this world and improvedthe health and wellbeing of millions of individualsthroughout southern Wisconsin and northernIllinois. In the work that we do, there is no oneand nothing more important than our patients and their experiences with us.

If you have benefited from our efforts, perhapsyou would consider becoming part of our GratefulPatient donor program as a way to show yourappreciation. Your gift of gratitude becomes aninstrument of healing for others and can be usedin any number of ways at your request. Your giftcan be earmarked to any of the following areas:

• General fund• Holly J. Barten Memorial Fund to help cancer patients and their families

• House of Mercy Homeless Center• Mercy Hospice Care• Mercy Health System Family MedicineResidency Program

• Mercy Medical Technology Fund• Mercy Regional Cancer Center• Mercy Regional Plastic Surgery, Skin and Laser Center

For complete information about the MercyFoundation, please call (608) 741-2422 or visit MercyHealthSystem.org.

39 support services

A health library at your fingertipsYou may have general questions about your condition outside of your doctor’s appointment. If you have access to the Internet, you haveaccess to the comprehensive health library at Mercy Health System’s website,MercyHealthSystem.org. Here you’ll find a huge online library that discusses conditions, procedures, medications, natural and alternativetreatments, plus offers a dictionary, interactivetools and more—in English or Spanish.

Comprehensive Inpatient RehabilitationSome cancers require only a quick fix. But othersmay require hospitalization and rehabilitation toaddress serious side effects caused by treatment.When these patients are discharged from the hospital, but are not yet ready to return home, theComprehensive Inpatient Rehabilitation Unit (CIR)at Mercy Hospital and Trauma Center provides an excellent option. CIR’s experienced team ofphysicians,therapists and rehabilitation nursesdesign patient-specific treatment plans to helpeach patient achieve his or her greatest level offunction and independence. When patients arealmost ready to return home, a therapist will visitthe home and assess it for safety concerns andmake recommendations. Acute care coordinators will also coordinate any services needed after discharge from the CIR. A physician’s referral is required to enter CIR programs.

Lymphadema Treatment ProgramCancer treatment that includes radiation therapyor removal of lymph nodes can sometimes lead to lymphedema, a condition characterized by uncontrolled swelling of a limb. If left untreated,the damage caused by lymphedema is irreversibleand progressive. Prevention is the key. However, if it does occur, Mercy’s Lymphedema TreatmentProgram can be very effective in helping individualslearn to control their condition and improve theirquality of life.

A physician’s referral is required to begin therapy.For more information, call the Mercy SportsMedicine and Rehabilitation Center in Janesville at (608) 755-7880, or in Lake Geneva (MercyWalworth Sports Medicine and RehabilitationCenter) at (262) 245-4980.

Nutrition counselingAccording to the American Cancer Society, athird of all cancers are related to diet and activity factors. Maintaining a healthy weight—and thuslowering your risk of getting cancer—is made easier by knowing what to eat. Knowing what to eat is also a concern for those battling cancer.Mercy Health System has several registered dietitians who can help you make healthy choices. A physician’s referral is required. Formore information, or to make an appointment, call Mercy HealthLine at (608) 756-6100 or (888) 39-MERCY.

Mercy Orthotics and Prosthetics CenterSome cancer treatments can affect walking andmovement or require the removal of a limb. The certified orthotists and prosthetists at the MercyOrthotics and Prosthetics Centers are experts at fabricating and custom-fitting orthopaedic bracesand prosthetic devices to help improve thepatient’s quality of life. To find a center near you,call Mercy HealthLine at (888) 39-MERCY.

40support services

Mercy Pain CenterThe physicians and nurses at the Mercy PainCenter, located on the ground floor of MercyHospital and Trauma Center, offer consultation for complex pain problems, whether chronic oracute. Upon referral by a physician or health care professional and acceptance into the program, the patient receives a comprehensiveevaluation and individualized pain management plan. For more information, call the Center at (608) 756-6049.

Pastoral carePart of Mercy’s mission is to meet the spiritualneeds of all patients, including those in our cancer treatment programs. When indicated orrequested, our hospital chaplain will meet withpatients and family members to assess spiritualneeds. We are happy to make a referral to thepatient’s own faith group for spiritual care and our chaplain will provide direct care when there is no faith group affiliation or when that person is unavailable. We also provide a chapel andhealing garden at Mercy Hospital and TraumaCenter as serene spaces for prayer, meditation,and reflection. For more information about Mercy’s pastoral care, call (608) 756-6000.

Mercy Regional Plastic Surgery, Skin and Laser CenterThe plastic surgeons at the Mercy Regional PlasticSurgery, Skin and Laser Center perform some ofthe most advanced medical procedures in theworld with the eye of an artist, bringing newshape and attractiveness to the human form. Theycan refashion and repair to wholeness the uniquefeatures that once were present but chance hasaltered. Our estheticians (Janesville) can helpshow cancer patients how to improve their skintone and texture, and ways to apply makeup to minimize the visible side effects of treatment.The Center has locations in Janesville and LakeGeneva, Wisconsin, and Woodstock and Vernon Hills, Illinois. For more information, please call (800) 236-6868 or visitMercyPlasticSurgery.org.

Effective treatment for skin cancerAs with most cancers, early detection and treat-ment of skin cancer is the key to a cure. Becausesome skin cancers can be large with an extensiveroot system, traditional treatments do not alwaysdetect and remove these deep areas of canceroustissue. One very successful way to treat skin cancer is with Mohs micrographic surgery. Only cancerous tissues are removed, whichspares healthy tissue in the affected area. Due to the methodical way in which tissue is removedand examined, Mohs surgery has one of the highest reported cure rates of all skin cancer treatments. Manish Gharia, MD, board certifieddermatologist and Mohs surgeon, practices at Mercy Walworth Hospital and Medical Center. For complete information, call the Center at (877) 893-5503.

41 support servicesTransfusion/infusion servicesOutpatient transfusion and infusion services are not only cost-efficient, but save time for ourpatients. Education sessions describing treatment,alternatives and possible side effects allowpatients the opportunity to have their questionsanswered. Transfusion services are coordinatedthrough the Mercy Treatment Coordination Center.For complete information, call (608) 756-6601.

Mercy Regional Urology CenterPeople with cancer of the bladder, prostate, testesand other urological cancers will find expert careat the Mercy Regional Urology Center. Here, the board certified urologists and support staffoffer the latest diagnostic tests, procedures, therapies and ongoing treatments available.Services are offered in Janesville and LakeGeneva, Wisconsin, and Harvard andWoodstock, Illinois. For general referral informa-tion, call (608) 741-6991 or (866) 486-6991.

Wigs for PatientsFor many people, especially women and children,the loss of hair due to medical conditions canoften lead to a loss of self-esteem and self-confi-dence. The Mercy Health System Association ofVolunteers established its award-winning Wigs for Patients program because it knows that whenpeople look good, they feel good. And whenthey feel good, they can deal with health challenges with confidence and a hopeful attitude.

The Wigs for Patients program offers high-qualitywigs, free or at limited cost, to patients in need.Features Hair & Nail Company and Coulterz Cutzin Janesville have specially trained cosmetologistsavailable to consult with our patients, cut and styletheir wigs, and teach them how to properly carefor their new wigs at home. For more information,or to make an appointment for a confidentialappointment in a private room, call Features Hair & Nail Company at (608) 756-0307 orCoulterz Cutz at (608) 752-2490.

Bereavement Support GroupFor individuals who are grieving the loss of a loved oneFor complete information: (608) 754-2201

Cancer Support GroupFor individuals affected by cancer and their support personLocation: Mercy Hospital JanesvilleFor complete information: (608) 756-6824

Commit to Quit Support GroupFor individuals who seek support in their efforts to quit smokingLocation: Henry Palmer Building, JanesvilleFor complete information: (608) 741-2411

Mercy Health System also offers support groups forstroke and polio survivors, children and adults withdiabetes, individuals with multiple sclerosis, and thoseaffected by sleep apnea. For complete information,call Mercy HealthLine at (608) 756-6100 or toll-free(888) 39-MERCY.

Support Groups

42Mercy MyChart helps you manage your life

View your medical information online• Review your medications, immunizations,

allergies and medical history.• Review new and past test results.• Review health education topics and

discharge instructions provided by your physician.

• Alerts will be sent to your personal email address when new information has been added to your account.

Stay in touch with your physician• Communicating with your physician

is as simple as sending an email—but even more secure.

• Request renewals of your medications.

Manage your appointments• Request your next appointment.• View summaries of your past and

upcoming appointments.

Access your family’s records• Access family members’ records,

including your children or otherfamily members you care for (authorization required).

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How to sign up for Mercy MyChart

4 easy steps. To request an activation code, go online tohttps://MyChart.MercyHealthSystem.org

. Click on “Sign Up Now”

. Complete the online form and click “Submit”

. Your activation code will be mailed to you in 5-10 business days

The activation code allows you to log on and create a Mercy MyChart ID and password. Use these to log on to our secure site. Mercy MyChart is available at no charge to our patients.

Battling cancer often means seeing differentdoctors, having a lot of tests and taking several medications. Mercy MyChart takes the hassle out of juggling all that information.It’s free, it’s easy, it’s secure and confidential.Best of all, you can check your informationany time of the day or night. All you need is an Internet connection.

What you’ll findat Mercy MyChart

Mercy MyChart support when you need it—24/7For assistance concerning Mercy MyChart, call us anytimeat (888) 99-MYCHART or (888) 996-9242.

MERCY REGIONAL CANCER CENTER1000 MINERAL POINT AVE., JANESVILLE