Hematology and Oncology A focus on Prostate Cancer

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I n t r o d u c t i o n

Dear Friend,

I am excited to present this year’s HealthPartners and Regions Hospital Hematology and Oncology Annual Report. We are an American College of Surgeons certified comprehensive community cancer center with an emphasis on patient care and a strong focus on education and clinical research.

From a patient care standpoint, we leverage the membership in our non-profit integrated health care system to improve the care we give our patients. We coordinate multidisciplinary cancer care through the use of an electronic medical record. We empower patients with tools to make informed choices including our online services, the Lundborg Patient Library and additional programs. We use standardized treatment algorithms based on national consensus guidelines to ensure all patients, including the underserved, receive the best treatment available. Finally, we measure outcomes and compare ourselves with national benchmarks to ensure quality cancer care delivery.

In this issue we highlight our multidisciplinary approach to early-stage prostate cancer. Prostate cancer is the most common cancer affecting men. The incidence of prostate cancer in men is higher than the incidence of breast cancer in women. Just as women have choices for the treatment of early-stage breast cancer, men also have choices for the treatment of early stage prostate cancer. Inside, we describe our shared decision making program and treatment options for men with early-stage disease.

Lastly, I take pride in “showing off” our new in-patient cancer unit. With the Regions 2009 expansion, we now have a new state-of-the-art in-patient facility for patients requiring hospitalization for their cancer care at Regions Hospital.

Once again, we appreciate the privilege of serving you and your patients. Please feel free to contact me if you have any questions about our program or have suggestions on ways we can improve the care we deliver.

Randy Hurley, M.D. Medical Director, HealthPartners/Regions Hematology and Cancer Care Program randy.w.hurley@healthpartners.com

Assistant Professor of Medicine Division of Hematology, Oncology and Transplantation University of Minnesota

Randy Hurley, M.D. ChairpersonCancer Program

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Regions Expansion 2009

This was an exciting year for Regions Hospital. We opened the new section of the hospital which includes a new main entrance, private patient rooms, emergency center, 20 operating rooms and a 450-space underground parking ramp.

As part of our expansion, patients needing inpatient care for their oncology treatments are now located in our new 6 South Section. This unit incorporates staff from three existing units into one central area. Nursing care is given to patients with differing requirements

including general medical care, intermediate care and intensive care. Physicians who direct the care of the patient unit include Regions hospitalists, intensivists, oncologists and other specialists as needed.

The 6 South Section includes 36 private patient rooms, each with their own bathroom. The new patient rooms were designed to accommodate differing care needs including rooms to suit special needs related to isolation. The patient rooms are large and include abundant natural light and spectacular views of downtown St. Paul. Each room has been designed to support our goal of being a patient/family centered hospital. Each room has a provider zone, patient zone and family zone. The provider space allows the caregiver staff, including nurses, closer access to the patient. Besides family space in the room, there are separate areas on the unit for private conferences as well as open areas for waiting. Our new unit brings our whole team together in a centralized location and allows us to be closer to the patient and family.

Lundborg Library nears 10-year milestone

The Patricia D. Lundborg Cancer Library at Regions Hospital offers cancer resources in a convenient, on-site facility. The library, created in 2000, is staffed by a librarian and provides resources for patients, their families and friends, hospital staff and members of the community. Annual library usage has continued to increase each year. The Library enters its 10th year of existence in 2010.

A continuum of care through palliative care and hospice

HealthPartners Cancer Care Centers partner with HealthPartners Hospice and the Regions Hospital Palliative Care Team to provide a continuum of care that enhances end of life care. Multidisciplinary team meetings are held weekly and include representatives from medical oncology, nursing, inpatient and outpatient social work, health psychology, HealthPartners hospice and palliative care team members. Through this partnership, care is coordinated from the hospital to the clinic to the patient’s home.

Our hematology and oncology patients are now located in new private patient rooms.

2009 Regions Hospital expansion includes new inpatient oncology unit.

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4 h e m a t o l o g y a n d o n c o l o g y

Survivorship Program enters second year

The HealthPartners and Regions Cancer Survivorship Program, under the direction of Dr. Kurt Demel, is entering its second year of providing comprehensive survivorship care plans to cancer patients. The success of the program has led to an invitation to participate in the Excellence in Survivorship care meeting. Sponsored by the Livestrong Survivorship Center of Excellence, this program is designed to foster and improve cancer survivorship care.

Cancer Survivors Advisory Council

The HealthPartners Cancer Survivors Advisory Council is a forum for patients who have completed their acute cancer treatment at Regions Hospital and Riverside Cancer Care Centers and who are now transitioning into long-term cancer management.

Members of the council are asked to share their experiences and to contribute ideas on how HealthPartners can improve the treatment and support of cancer survivors. The twelve-member council met seven times in 2009 and was asked to make recommendations on services already offered and to assist with the design of new services. The first topic presented to the council was patient education materials. Feedback from the council guided the changes we made. Educational materials are now easier to understand and more specific to the needs of the patient.

The experiences and recommendations of the advisory council were also an integral part of the development of two new programs that began in late 2009. “Let’s Get Physical” is a beginner-level physical activity class tailored to the needs of cancer patients who want to improve their level of physical conditioning. “Renewing Life” is a transformative program of education and support that engages participants in an exploration of the possibilities for growth in living with serious illness. Both of these programs are lead by cancer survivors and are available at a minimal cost.

Colleen Morton, MD, manages the hemostasis and thrombosis program. She has interest in thrombotic

disorders of pregnancy and is working with the U of M to develop city-wide protocols to standardize treatment of bleeding and clotting disorders.

Gretchen Ibele, MD,treats adult patients with oncologic and hematologic diseases and was named to

the Minnesota Monthly Top Doctors for Women 2009 list.

Dan Schneider, MD, had the highest patient-rated satisfaction of over 220 specialty

physicians in the HealthPartners system.

Our hematology and oncology program utilizes a Cancer Survivors Advisory Council to help us make recommendations on new and existing patient services.Back row: Scott Cruse, Marge Watry, Ron Bentley, Carolyn Markwood Nyberg, Churon Webb, Micky Gutzmann, Gobind Tarchand, Marjorie Moore Front row: Deanna McWilliam, Joe Kennedy, Judy Clasen

Kurt Demel, MD, is the medical director of the survivorship program and recently completed his MBA.

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E d u c a t i o n

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Training tomorrow’s hematologist/oncologists — HealthPartners’ partnership with the University of Minnesota Division of Hematology, Oncology and Transplantation Fellowship program

Regions Hospital is a clinical training site for the University of Minnesota Hematology/Oncology Fellowship program and is regarded as one of the highest ranked rotations by University Fellows. Dr. Jeff Jaffe heads the teaching program at Regions Hospital which combines clinical experience with specific teaching conferences. With over 20 years of teaching experience, Dr. Jaffe and other HealthPartners oncologists have mentored many of the oncologists that practice in the Twin Cities area. This year, three HealthPartners oncologists were nominated for a teaching award among teaching faculty at the University of Minnesota, Veterans Administration Hospital and Hennepin County Medical Center. Dr. Balkrishna Jahagirdar won the award for outstanding clinical mentorship.

Regions hematology and oncology faculty provide elective rotations for the University of Minnesota internal medicine residents and teach in the Medical School second year hematology course for medical students. Faculty also coordinate six hours of hematology and oncology lectures in the University’s Global Health course.

HealthPartners hosts Oncology Nursing Symposium

In April 2009, HealthPartners hosted an Oncology Nursing Symposium. This half-day event was certified for continuing education credit by the Oncology Nursing Society and was attended by over 60 nurses and health care professionals from the Twin Cities area and western Wisconsin. A wide range of topics were discussed including oncologic emergencies, survivorship and new trends in cancer clinical trials. We look forward to a second symposium in April 2010.

Regions Breast Health Center partners with University of Minnesota to develop breast radiology fellowship

The Regions Hospital Breast Health Center partnered with the University of Minnesota, Saint Paul Radiology and four radiology practices in the Twin Cities to develop a Breast Imaging Fellowship program to train two board certified radiologists each year in the radiology subspecialty of breast imaging. This unique program has the advantage of combining the comprehensive research program in breast imaging at the University of Minnesota with the excellent clinical practices that are present at community centers, including the Regions Hospital Breast Health Center. The partnership will allow the program to attract highly qualified and motivated individuals into the arena of breast imaging and will increase the number of dedicated breast imagers to serve our community in the future.

Scott Cruse, Lead Oncology SocialWorker, has interest in working with patients going through the trauma of cancer, facilitating patient support groups and developing programs and services for patients.

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Balkrishna Jahagirdar, MD, received the 2009 Outstanding Clinical Teacher award from the University of Minnesota Hematology Oncology Fellowship Program.

Joe Tashjian, MD, is the coordinator of the breast radiology fellowship program and is a radiologist with St. Paul Radiology who specializes in chest and breast imaging and diagnosis.

Jeff Jaffe, MD, practices medical oncology and hematology with interests in breast cancer and hematologic malignancies. He is also the Regions site director for Hematology/Oncology educational programs for the University of Minnesota Medical School.

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Minnesota CGOP and Minnesota CCOP to merge

Dr. Dan Anderson of HealthPartners and Regions Hospital is the director of the Minnesota Cooperative Group Outreach Program (CGOP). The CGOP provides access to over 80 National Cancer Institute-sponsored clinical trials for patients with cancer. HealthPartners provides the largest number of additions to clinical trials in this program. Plans are underway to merge CGOP with the Minnesota Community Cancer Oncology Program (CCOP) and develop an even larger consortium with expanded access to clinical trials.

Cancer Research Network celebrates 10th year

Ten years ago, HealthPartners Research Foundation (HPRF) became a participating organization of the Cancer Research Network (CRN). The CRN is a consortium of 14 non-profit research centers that collectively provide care to over 11 million individuals across the United States. Through the CRN connection, HealthPartners has also been involved with the Minnesota Cancer Alliance (MCA), a consortium developed to implement Minnesota’s Comprehensive Cancer Control Plan.

Colorectal cancer Survivor Care Plan in developmentHealthPartners Research Foundation, in collaboration with the Minnesota Cancer Alliance, has received a grant from the American Cancer Society to develop a Survivorship Care Plan specifically for colorectal cancer. This two-year research project will involve obtaining input from health care providers and survivors across Minnesota on elements they would like to see incorporated into a care plan.

Pilot project examines text messaging to promote healthy behaviors among adolescent cancer survivors

Dr. Emily Parker, a researcher at HealthPartners Research Foundation, is conducting a pilot study using text messaging to test weight gain prevention in adolescent survivors of childhood cancers. Due to late effects of treatment and disease, survivors of childhood cancers are at increased risk of unhealthy weight gain, obesity and cardiometabolic disease. Innovative methods of intervention are needed to address the increased risk of obesity in young cancer survivors.

Data collection on breast cancer in older women continues

Feifei Wei, PhD, is the HealthPartners principal investigator on a continuation study of long-term (5-year) survivors of breast cancer of those 65 and older. The study aims to understand and reduce the adverse effects of cancer treatment in older adults. Additional information will be collected about this breast cancer cohort through monitoring that will continue for 15 years following treatment.

Cheri Rolnick, PhD, MPH, is the associate director of research for the HPRF

and a member of the Cancer Research Network. She will take over as the Chair of the Minnesota Cancer Alliance Steering committee in 2010.

Daniel Anderson, MD, is the principal investigator and director for the

Minnesota Cooperative Group Outreach Program.

Kathy Fuhrmann, MS, Certified Genetic Counselor, provides genetic counseling

services for the Cancer Care Center for individuals with a personal history of cancer or a strong family history of cancers.

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Mark Bisignani, MD, is the medical director of the Regions Radiation Therapy Program and has expertise with intensity modulated and image guided radiation therapy.

Cesar Ercole, MD, has clinical interest in urologic oncology, prostate disease and general urology.

Focus on prostate cancer

Prostate cancer is the most common cancer among American men. Nearly one in six men will develop prostate cancer in their lifetime. The incidence is highest in African American men and lowest in Asians and Native Americans. In 2009, 192,000 new cases of prostate cancer will be diagnosed. With the advent of the prostate specific antigen (PSA) blood test, more and more men are being diagnosed at an earlier stage when cancer is still localized to the prostate gland.

HealthPartners and Regions Hospital prostate cancer program

HealthPartners and Regions Hospital treated 92 new cases of prostate cancer in 2008 compared to just 39 cases in 2003. This increase is in no small part due to the development of a dedicated multidisciplinary prostate cancer team. Ninety percent of the cancers in 2008 were diagnosed at an early stage of disease. To facilitate multidisciplinary treatment planning for patients with urologic cancers, we participate in specialized Urologic Tumor Conferences and Family Tumor Conferences.

The Surveillance, Epidemiology and End Result (SEER) Program of the National Cancer Institute reports 5-year relative survival rates for prostate cancers diagnosed between 1999 and 2005. Relative survival rates compare survival of cancer patients with those of the general population to estimate the effect of cancer. The SEER database reports a relative survival rate of 100 percent for localized (stage 1 and 2) and regional (stage 3) prostate cancer and a 30 percent 5-year relative survival rate for advanced stage 4 disease. The Regions Hospital Cancer Registry reports overall survival rates which includes death due to unrelated causes. Therefore, it is not directly comparable to SEER data. The Regions Hospital Cancer Registry data reports an 84 percent 5-year overall survival rate for localized disease, a 100 percent 5-year survival rate for regional stage 3 disease and a 20 percent 5-year overall survival rate for advanced stage 4 disease. The Regions prostate cancer 5-year survival (2003-2008) can also be compared to American Joint Committee on Cancer (AJCC) staging using National Cancer Data Base (NCDB) statistics. Because of methodology, none of the Regions cases are stage 1. However, the 5-year survival for stage 2, 3 and 4 prostate cancers at Regions Hospital is 85, 100 and 36 percent. This compares to the NCDB 5-year survival of 88, 89 and 37 percent for stage 2, 3 and 4 prostate cancers respectively.

Parker Eberwein, MD, is the Chair of Urology and Director of Robotic Surgery for Regions Hospital and HealthPartners. His interests are minimally invasive surgical techniques, endourology and cryotherapy treatment of urologic malignancies.

Diana Christensen Johnston and Carol Jirik are Oncology Certified Nurses that supervise the Regions and Riverside Cancer Care Centers. Together they have over 50 years of oncology experience.

Prostate cancer is the most common cancer among American men. Nearly one in six men will develop prostate cancer in their lifetime.

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Multidisciplinary planning and shared decision in the treatment of early-stage prostate cancer

Early-stage prostate cancer is localized prostate cancer that has not spread beyond the prostate. Men with newly diagnosed early-stage prostate cancer often have several treatment options available to them. This may include surgery, radiation therapy, watchful waiting, and in some instances, cryosurgery. Multidisciplinary treatment planning involves a team of specialists including a urologic surgeon, radiation oncologist, and occasionally a medical oncologist. We offer patients and their families a shared decision-making experience allowing patients to participate fully in decisions regarding their care.

Treatment options for localized prostate cancer

Robotic Prostatectomy at Regions HospitalRobotic-assisted laparoscopic prostatectomy is a form of minimally invasive prostate surgery performed by Dr. Parker Eberwein and Dr. Cesar Ercole. Robotic prostatectomy may be a treatment option for patients with localized prostate cancer. Compared to a traditional open radical retropubic prostatectomy, advantages* for patients include a faster recovery time, shorter hospital stay, and potentially reduced bleeding and less urinary and erectile dysfunction.

Cryosurgery for the treatment of localized prostate cancerCryosurgery is the use of extremely cold temperatures to freeze prostate tumors and kill cancer cells. During an outpatient procedure, several small needle-like cryoprobes are inserted into the prostate gland under ultrasound guidance. Argon gas is then circulated through these probes during controlled freezing of the prostate gland.

Short term PSA-relapse-free survival is comparable to radiation therapy with acceptable health-related quality of life-based outcomes. The American Urological Association’s 2008 Best Practices Policy Statement on prostate cryosurgery indicates that in selected patients, prostate cryosurgery may be an option for the treatment of early stage disease. Cryosurgery has also been used effectively to treat recurrent prostate cancer after radiation therapy.

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da Vinci Surgical System robot

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*As with any surgical procedure these benefits cannot be guaranteed as surgery is both patient-specific and procedure specific.

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Regions Hospital has been designated as an International Center of Excellence for Cryotherapy. Treatment efforts are being led by Dr. Parker Eberwein who has over a decade of experience with this technique.

Intensity-Modulated Radiation Therapy

Radiation therapy (RT) and radical prostatectomy are treatment options with the longest follow-up for patients with localized prostate cancer. Long-term outcomes are similar.

The goal of RT for men with localized prostate cancer is the delivery of a therapeutic dose of radiation to the prostate gland while minimizing the dose to normal surrounding tissues. The prostate gland lies in close proximity to the rectum and bladder. Avoidance of these structures decreases the risk of long-term side effects. In recent years, new conformal techniques have been developed which allow the delivery of higher doses to the prostate and better spare surrounding tissues. Intensity modulated radiation therapy (IMRT) is a technique which enables the radiation dose to be ‘sculpted’ around the prostate gland. Gold seed markers are usually placed in the prostate gland prior to a course of radiation therapy. This is helpful in localizing the gland (image-guided radiation therapy) since the prostate can shift a small degree from day to day. In general, treatment is very well tolerated. There can be a few minor urinary symptoms such as urgency or frequency during radiation. Treatments typically take 15-20 minutes each day over an eight and a half week period of time. Following radiation therapy, response is monitored by observing the (PSA) level, which is a simple blood test.

Both intensity-modulated and image-guided radiation therapy are available at the Regions Radiation Therapy Center.

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Radiation therapy is an option for prostate cancer treatment.

Cryosurgery treatment device

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Since 1984, our Cancer Registry has accumulated over 17,000 cancer cases and is actively following more than 5,700 patients

The main goal of the Cancer Registry is to serve as a primary source of cancer information for cancer care professionals. The Cancer Registry contains a wealth of valuable data, including demographics, histology and staging, treatment modalities and clinical outcomes. Our registrars also spend time on follow-up of these cases, resulting in a 93 percent follow-up rate.

The Registry is also responsible for scheduling weekly cancer conferences. A significant number of our cancer patients have their diagnosis and treatment discussed weekly by a multidisciplinary group of cancer care professionals.

The American College of Surgeons requires that managing physicians be responsible for documenting accurate staging of cancer. Our Cancer Registry has a 98 percent accuracy rate for cancer staging.

To request registry data, please contact our registry team at: 651-254-2821

Regions Hospital Cancer Registry 2008

Total Cases in the Cancer Registry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17,081(Since January 1, 1984.)

Total Actively Followed Cases in the Cancer Registry in 2008 . . . . . . . . . . . . . . 5,708

New Cases in 2008 New Analytic Cases in 2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,103 (Cases initially diagnosed and/or treated at Regions Hospital.) New Non-analytic Cases in 2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 (Cases that receive subsequent treatment/care at Regions Hospital following initial diagnosis and treatment at another facility.)

Total New Cases in 2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,160

Sue Braaten and Margo HessRegions Hospital cancer registrars

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A review of the five-year trends shows an increase in the number of prostate cancer cases. This likely reflects an increased role of Regions as a referral center and the increased use of our multidisciplinary prostate cancer approach.

Major Cancer Sites — 2008, Regions Hospital

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BREAST

300

270

240

210

180

150

120

90

60

30

004 05 06 07 08

LUNG COLORECTAL PROSTATE HEAD & NECK MELANOMAGYNECOLOGIC(excluding IN II)*

LEUKEMIA/LYMPHOMA

04 05 06 07 08 04 05 06 07 08 04 05 06 07 08 04 05 06 07 08 04 05 06 07 08 04 05 06 07 08 04 05 06 07 08

202

249

288

280

270

131

145

111123

137

93

75 77

67

8171

44 39

26 25

13

36 38

60

92

31 2835 36 38

2833

48 50 49

37

114107 102

90

*Excluding cervical intraepithelial neoplasia (CIN) III, and benign and borderline malignancies

Female

SITE PERCENT Breast 43% Lung 15% Leukemia/Lymphoma 10% All others 9% Colorectal 6% Brain 4% Urinary 4% Melanoma 3% Gynecologic (excluding CIN III)* 2% Head and Neck 2% Pancreas 1% Stomach/Small Bowel 1%

Male

SITE PERCENT Lung 19% Leukemia/Lymphoma 17% All others 16% Prostate 9% Urinary 9% Colorectal 8% Melanoma 7% Head and Neck 6% Brain 3% Pancreas 3% Breast 2% Stomach/Small Bowel 1%

Trends in cancer diagnosis at Regions Hospital

Professional and Community Involvement

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Professional and Community Involvement

Professional Organizations & CertificationsAlpha Omega AlphaAmerican Association of Medical DosimetristsAmerican Association of Physicists in Medicine: AAPM - local chapter presidentAmerican Association of Physicists in Medicine: faculty member and presenterAmerican Association of Physicists in Medicine: local chapter secretaryAmerican College of SurgeonsAmerican Freestanding Radiation Oncology Centers American Medical Association American Registry of Radiologic Technologists American Society of Clinical Oncology American Society of HematologyAmerican Society of Radiologic TechnologistsAmerican Society of Therapeutic Radiology and Oncology American society of Tropical Medicine and HygieneAssociation of Community Cancer CentersMinnesota Cancer AllianceMinnesota Society of Clinical OncologyOncology Nursing SocietySociety for Surgery of the Alimentary TractState Advisory Board for Radiation and Radioactive MaterialWilderness Medical Society

Greta Anderson, unit support secretary, completed the Breast Cancer 3-Day event RNs Wendy Ness, Heidi Madison, Mary Srb and Kathy Heitzinger attended 2-day oncology conference at Mayo ClinicKari Richter, RN, completed the Relay for Life of White Bear Lake Heather Peterson, RN, completed and was team captain for Relay for Life of Woodbury C81 staff supported cancer survivor and her children with holiday giving Sheryl Bendickson, RN, was mission chair for the White Bear Lake area American Cancer Society and captain of We Care Walkers for the Relay for Life for White Bear Lake

Cheryl Moulton, RN, participated in the Breast Cancer 3-Day with her daughter Stacey Schuette and Donnie Price, RN,Race for the Cure participantsLeigh Strassman, Breast Cancer 3-Day volunteerJessica Appert, Big Brothers and Sisters and United Way volunteerMark Towsley, Boy Scout leader and MN Department of Health Advisory Committee memberRegions Cancer Care Center staff supported a patient and her children with holiday giving

Big Brother Big Sister The Breast Cancer 3-Day eventTwin Cities Marathon Habitat for Humanity Animal Humane SocietyLeague of Women VotersClassroom and Youth Groups VolunteersGirl and Boy ScoutsSunday School TeachersLocal Food Shelves

Volunteer FirefighterLocal Women’s Shelter Volunteers, including President of the BoardAmerican Red Cross People and Experience AmbassadorMS/150 Bike Ride Relay for Life Participants and VolunteersAl-a NonHearing Loss Association of America

THIS PO

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Individual Accomplishments

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Tan, WW, Hillman DW, Salim M, Northfelt DW, Anderson DM, Stella PJ, Niedringhaus R, Bernath AM, Gamini SS, Palmieri F, Perez EA. (2009). Phase 2 trial of weekly irinotecan hydrochloride and docetaxel in refractory metastatic breast cancer: a north central cancer treatment group (ncctg) trial. Breast Cancer Res Treat, 106(1), 71-72.

Glasser L, Meloni-Ehrig A, Greaves W, Demel KC, Butera J. (2009). Synchronous development of acute myeloid leukemia in recipient and donor after allogeneic bone marrow transplantation: report of a case with comments on donor evaluation. Transfusion, 49(3), 555-562.

Hussein K, Jahagirdar B, Gupta P, Burns L, Larsen K, Weisdorf D. (2008). Day 14 bone marrow biopsy in predicting complete remission and survival in acute myeloid leukemia. Am J Hematol, 83(6), 446-50.

Tuttle, TM Jarosek S, Habermann EB, Arrington A, Abraham A, Morris TJ, Virnig BA. (2009). Increasing rates of contralateral prophylactic mastectomy among patients with ductal carcinoma in situ. J Clin Oncol, 27(9), 1362-1367.

Williams B, Morton C. (2008). Cerebral vascular accident in a patient with reactive thrombocytosis: a rare cause of stroke. Am J Med Sci. 336(3), 279-81.

Coleman LA, Kottke TE, Rank B, Reding DJ, Selna M, Isham GJ, Nelson AF, Greenlee RT. (2008). Partnering care delivery and research to optimize health. Clin Med Res, 6(3-4), 113-118.

Rank B. (2008). Executive physicals — bad medicine on three counts. N Engl J Med. 359(14), 1424-5.

Jackson, J, Rolnick SJ. (2009). Knowledge, attitudes and preferences regarding advance directives among patients of a managed care organization. Am J Man Care, 15(3), 177-186.

McClure, JB, Divine G, Alexander G, Tolsma D, Rolnick SJ, Stopponi M, et al. (2009). A Comparison of smokers’ and nonsmokers’ fruit and vegetable intake and relevant psychosocial factors. Behav Med, 35(1), 14-22.

Altschuler A, Nekhlyudov L, Rolnick SJ, Greene SM, Elmore JG, West CN, Herrinton LJ, Harris EL, Fletcher SW, Emmons KM, Geiger AM. (2008). Positive, negative, and disparate: women’s differing long-term psychosocial experiences of bilateral or contralateral prophylactic mastectomy. Breast J. 14(1), 25-32.

Altschuler, A, Nekhlyudov L, Rolnick SJ, Greene SM, Elmore JG, West CN, Herrinton LJ, Harris EL, Fletcher SW, Emmons KM, Geiger AM. (2009). Positive, negative, and disparate--women’s differing long-term psychosocial experiences of bilateral or contralateral prophylactic mastectomy. Breast J, 14(1), 25-32.

Rolnick SJ, Jackson JM, Amundson JH. (2009). Development, Implementation and Evaluation of an Electronic Medical Record Prompt for Bone Density Testing. Health Informatics Journal, [At press].

Stopponi, MA, Ritzwoller DP, Alexander GL, Carroll NM, McClure JB, Divine GW, Calvi JH, Rolnick SJ, Johnson CC. (2009). Recruitment to a web-based nutritional intervention trial. J Med Internet Research, 11, 1-11.

Rolnick, SJ, Calvi J, Heimendinger J, McClure JB, Kelley M, Johnson CC, Alexander GL. (2009). Focus groups inform a web-based program to increase fruit and vegetable intake. Pat Ed and Couns, 7(2), 314-318.

Sukhanova A, Ritzwoller DP, Rolnick SJ, Calvi JH, McClure J, Alexander G, Johnson CC. (2009). Focus groups inform a web-based program to increase fruit and vegetable intake. Patient Educ Couns, 77(2), 314-318.

P u b l i c a t i o n sTH

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640 Jackson StreetSt. Paul, MN 55101651-254-3572

2220 Riverside Avenue SouthMinneapolis, MN 55454612-349-8374

Hematology and Oncology A focus on Prostate Cancer

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Hematologists/Oncologists

Dan Anderson, MDKurt Demel, MDRandy Hurley, MDGretchen Ibele, MDJeffrry Jaffe, MDBal Jahagirdar, MDColleen Morton, MDBrian Rank, MDDaniel Schneider, MD

Multidisciplinary Team

Specialized Surgical OncologistsRadiation Oncologists and TherapistsOncology Certified NursesClinical Laboratory TechniciansPathologistsPain Management ProvidersGenetics CounselorSocial WorkersPsychotherapist

PharmacistsCertified Medical AssistantsHome Care & Hospice CaregiversDietitiansChaplains Cancer RegistrarsAmbulatory CoordinatorsMedical Office Assistants

Physician Hotline

651-254-3505 (for physician questions/consultations only)

Multidisciplinary Team

952-967-7616

Online

regionshospital.com/cancer healthpartners.com/cancer

P u b l i c a t i o n s