memorialhealth.org

Arthur Temple Sr. Regional Cancer Center Report to the Community 2009

Cancer Committee Members 2009

Munir Ahmad, MDChairman

Bramham Reddy, MDCancer Liaison Physician

Sidney C. Roberts, MDRadiation Oncology

Kavitha Pinnamaneni, MDMedical Oncology

Bratcher Runyan, MDGeneral Surgery

Thomas McLaurin, MDDiagnostic Radiology

David Todd, MDPathology

Mariela Vasquez, MDPathology

J. B. Alexander, MDOtolaryngology (ENT)

Samuel Santiago, MDInternal Medicine

Abraham Cheriyan, MDPulmonology

Bryant KrenekPresident & Chief Executive Officer

Les LeachVice President & Chief Operating Officer

Mario Estrella, RNVice President of Patient Services

Kristi GayChief Financial Officer

David HearneChief Compliance Officer

Jennie Ferguson, CPCSDirector of Medical Affairs

Brenda Holbert-Fernandez, FNP-BC, AOCNPCancer Center Nurse Practitioner

Andra Self, BSMT(ASCP), MEd MBA Director of Rehabilitation Services

Jewel Randle, RT(R)(T)Radiation Therapist

Doris Duffield, RNNurse Manager, Renal and Oncology

Cindy Long, RNWomen’s Special Services

Joy RichAmerican Cancer Society Representative

Amy Varnado, LMSWCancer Center Social Worker

Jackie GilmoreCancer Registry Coordinator

Charlotte Wammel, CTRTumor Registrar

Bill MalnarDirector/Imaging Services

Non-Hodgkins Lymphoma Study Non-Hodgkin’s lymphoma is the fifth most common cancer diagnosed in the United States and at MHSET, excluding non-melanoma skin cancers. According to the National Cancer Institute, an estimated 65,980 new cases of non-Hodgkin’s lymphoma will be diagnosed in the United States in 2009. Of those, it is estimated that 19,500 will die. Non-Hodgkin’s lymphoma is cancer that starts in lymphoid, or lymphatic, tissue. The lymph system is a complex network of cells and channels that runs throughout the body and defends against disease and infection. Most of the time, lymphomas arise in bean-shaped structures called lymph nodes. Lymphomas start from lymphocytes in either lymph nodes or other sites of lymphoid tissue, such as the bone marrow, and may spread from there. The two main types of lymphocytes are B lymphocytes (B cells) or T lymphocytes (T cells). B-cell lymphomas account for 85% of non-Hodgkin’s lymphoma and T-cell lymphomas make up about 15%. Non-Hodgkin’s lymphoma tend to progress in a non-systematic and unpredictable manner. These lymphomas are categorized into follicular or diffuse types depending on the growth pattern within the lymph node when viewed under a microscope. Follicular lymphomas are clumped together similar to the normal follicle pattern seen in lymph nodes. The average age of someone with this type is 60 years old. This is considered a slow-growing cancer, but in advanced stages it is usually not considered curable by standard treatment. Five-year survival after diagnosis is about 60-70%. Over time, follicular lymphomas can transform into the faster growing diffuse large B-cell lymphoma. Diffuse large B-cell lymphoma makes up about 31% of all lymphomas. It is a fast-growing disease that usually presents with a rapidly growing mass in the body or in a lymph node that can be felt by the patient. One-third of these lymphomas are confined to one part of the body. When localized, it is considered to be more curable than when it has spread to other parts of the body. It can arise in any age group, but the average age at diagnosis is in the mid-60s. The cure rate tends to be about 40-50%. Some of the less common non-Hodgkin’s lymphomas are MALT lymphoma, Mantle cell lymphoma, Burkitt’s lymphoma, AIDS-related B-cell lymphoma, primary CNS lymphoma and T-cell lymphomas. The most aggressive types of lymphoma are Burkitt’s lymphoma, lymphoblastic lymphoma, and AIDS-related lymphoma. The most common symptoms with non-Hodgkin’s lymphoma are swollen glands in the neck, armpits, or groin. The enlarged lymph nodes are usually painless and do not respond to antibiotics. Other symptoms can include loss of appetite, weight loss, nausea, vomiting, abdominal pain, back pressure, itching, bone pain, headaches, constant coughing, abnormal pressure and congestion in face, neck, and upper chest. Fatigue, weakness, flu-like symptoms, fever and night sweats may occur. A person should seek medical care if they experience any of these symptoms for more than two weeks. On physical exam, a physician may find enlarged lymph nodes or an enlarged spleen or liver. Further work-up with a biopsy and diagnostic x-rays would be expected. From 1998-2001, there were 51 cases of non-Hodgkin’s lymphoma diagnosed and/or treated at Memorial Health System of East Texas. Age at diagnosis ranged from 20s to 90s, with the average age in the 60s and 70s, as expected. Stage at diagnosis is weighted toward stage IV, typical for this disease. Our survival data compares quite favorably with regional and national data published on the American College of Surgeons website, reflecting the quality of care delivered locally.

15

10

5

0

20’s 30’s 40’s 50’s 60’s 70’s 80’s 90’s

1

34

9

11

14

6

3

30

20

10

0Stage I Stage II Stage III Stage IV

109

5

27

1 year 2 year 3 year 4 year 5 year

80

70

60

50

40

30

20

10

0

Perc

ent

Stage IV Survival

MHSET Regional National

100

80

60

40

20

01 year 2 years 3 years 4 years 5 years

Years of Survival

Perc

ent o

f Pat

ient

Sur

viva

l

MHSET Regional National

Non-Hodkin’s Lymphoma 5 Year SurvivalAll Stages Combined (1998-2001)

Chairman’s Report2009 was a year marked by record loss of jobs and a subsequent

staggering loss of health care coverage of many thousands of Americans. It was also a time of great challenge for the community. Despite the difficult period, our physicians and hospital continued to provide quality services to the region. We admire the dedication and the willingness of the health care community to provide exceptional medical care to those in need.

Despite the turbulent times, we have managed nevertheless to achieve several goals. We have implemented the use of NCCN guidelines as a standard for treatment decision making at tumor board conferences and increased our outreach through the ACS Cancer Prevention Study and the African American Outreach Program provided by Women’s Special Services. Moreover, we have implemented new software to maintain accurate and timely follow-up, initiated the utilization of electronic cancer staging forms, and expanded the registry to two personnel. We have recognized the need of cancer patients for rehabilitation services and formed a closer working relationship with our rehab colleagues. More chemotherapy nurses have become oncology certified. And, this year’s Power of Pink!, an annual community breast cancer awareness event, was a great success with an attendance exceeding 650.

We have also made great strides in the surgical arena. Memorial Health System of East Texas is one of the first medical facilities to acquire the da Vinci high definition robotic surgery system. This device has conferred significant benefits to patients in comparison to traditional surgical methods. Robotic procedures are less invasive, resulting in shorter recovery times, smaller incisions, and reduced blood loss. Robotic use is rapidly expanding to include cardiothoracic, urologic, gynecologic, and other surgical procedures.

On the medical oncology front, we have continued our transition from traditional chemotherapy to more targeted therapeutic approaches. The new research in medical oncology has expanded the number and diversity of approaches to the treatment of patients who have had limited success with more conventional treatment modalities. In radiation oncology, we have continued our commitment to provide novel and safer techniques for treatment.

Our efforts were once again rewarded with our being accredited by the American College of Surgeons; we remain the only accredited cancer center in the region. Memorial Health System of East Texas is dedicated to providing prevention, education, and treatment of cancer in a welcoming, comfortable environment. We are committed to our collaborations with other non-profit groups and community outreach programs in order to provide our disadvantaged patients with access to the health care system.

We are seeing a decrease in cancer mortality nationwide for the first time in history. With increased access to care and improved technology for diagnosis, treatment, and supportive care, we are convinced that the future of cancer care is bright.

Munir Ahmad, MDChairman, Cancer CommitteeMemorial Health System of East Texas

The Tumor Registry is a critical component of the Cancer Program at Memorial Health System of East Texas, supporting efforts in the area of patient care, education and research. Identification and monitoring of all cases meeting the eligibility criteria established by the hospital’s Cancer Committee is a labor-intensive task which plays a vital part in the accreditation of the hospital’s cancer program by the American College of Surgeons.

The Tumor Registry has been in existence at Memorial Health System of East Texas since 1990. The Registry, under the direction of the Cancer Committee, maintains a complete database of all cancer cases diagnosed and/or treated at Memorial. In 2008 there were 553 newly diagnosed and/or treated cancer cases at Memorial.

In order to encourage continued medical surveillance and to provide valid end-result statistics, every patient in the Registry is followed on an anneal basis. The Registry, with the aid of its computerized database, is able to provide valid information regarding the current medical status of the patient to the physicians following the case.

The Registry also provides the physicians and hospital with survival information about patients treated in our Cancer Center. Patient confidentiality is strictly enforced under HIPAA guidelines. Currently we are able to maintain a high rate of successful follow-up.

The Registry’s efforts in these areas yield useful demographic, diagnostic, therapeutic and follow-up data. This data is used to help support efforts in reviewing patient care and treatment procedures. Our cancer program is accredited by the American College of Surgeons Commission on Cancer. Registry data is also very useful in helping to create more effective patient education programs or research protocols.

Physicians may request information or cancer statistics by contacting the Registry at (936) 639-7141.

Tumor Registry Report

http://quickfacts.census.gov

PRIMARY SITE TABLE 2008

TOTAL 553 100%

Tumor Board Conferences 2008

Tumor Board conferences are educational conferences held for the benefit of the Medical Staff, allied health personnel and others. In 2008, a total of 106 different, interesting, controversial or unusual cases of cancer were presented in a forum designed to give clinicians a way to share opinions and discuss treatment options that may improve individual patient care. In addition, category 1 Continuing Medical Education (CME) credit is offered for each meeting a physician attends.

Cases discussed in 2008 included major sites such as lung, breast, colorectal, prostate, and lymphoma, as well as other gastrointestinal and genitourinary sites, head and neck cancers, sarcomas, brain tumors, thyroid cancer, melanoma, and metastatic disease.

The ability to present cases in a multi-disciplinary forum, where treatment options can be discussed in a prospective fashion, is one of the criteria that set an accredited cancer program apart. Almost all of our presentations were prospectively addressed, although an occasional patient was presented in follow-up so that our members could learn the outcome of our discussions.

StatisticsTotal Number of Cases in Registry 12,475Analytical Cases (diagnosed and/or treated here) 9,826Total Number of Expired Cases 5,226

MHSET Primary Site Table 2008In 2009, there were 553 new cases of cancer registered at Memorial Health System

of East Texas in Lufkin. The most common sites diagnosed and/or treated were lung (19.5%), breast (15.0%), colorectal (14.3%), prostate (8.7%), and non-Hodgkin’s lymphoma (4.7%).

MHSET Major Site Comparison 2008We continue to see a higher percentage of lung cancer cases than state or national

statistics. According to The State of Tobacco Control in Texas–2007 by Gorlach and Sanchez (a Policy Brief published by the Institute for Health Policy at the University of Texas School of Public Health):

“As of 2006, 21.2% of Texans use tobacco products. According to the Youth Tobacco Survey and Texas School Survey, tobacco use initiation is most common among youth, with prevalence rising as grade level increases. The cigarette smoking rate in Texas is highest among males between the ages 18-24, primarily those earning less than $35,000 with 9-11 years of education.ii,iii”

We previously reported that census data available at http://quickfacts.census.govshow that in 2004 17.3% of Angelina County residents were below the poverty level, compared with 16.2% for the state and 12.7% for the nation. Likewise, Angelina County residents have a lower percentage of high school graduates (71.2%) than Texas (75.7%) of the nation as a whole (80.4%). Extrapolating from the above, Angelina County has a population base that is statistically more likely to smoke.

ITexas Department of State Health Services. Behavioral Risk Factor Surveillance System, 2006. Department of State Health Services. Prevalence of Tobacco Use Among Public Middle and High School Students 1999-2001. Texas Youth Tobacco Survey. 2001. IIICDC, National Center for Health Statistics. Health, United States, 2003 With Chartbook on Trends in the Health of Americans. Hyattsville, MD: U.S. Department of Health and Human Services, CDC, 2003:141.

PRIMARY SITE TABLE 2008SITE NUMBER PERCENT

LungLung 108 19.5%Breast 83 15.0%Colorectal 79 14.3%Prostate 48 8.7%Non-Hodgkin’s LymphomaNon-Hodgkin’s Lymphoma 26 4.7%Melanoma 21 3.8%Bladder 17 3.1%Uterus 16 2.9%Kidney and Renal PelvisKidney and Renal Pelvis 15 2.7%Brain 13 2.4%Unknown Or Ill-Defined 13 2.4%Other Nervous System 11 2.0%ThyroidThyroid 10 1.8%Stomach 9 1.6%EsophagusEsophagus 8 1.4%OvaryOvary 6 1.1%Cervix 5 .9%Pancreas 5 .9%Liver 5 .9%Leukemia 5 .9%Multiple MyelomaMultiple Myeloma 5 .9%Tonsil 4 .7%LarynxLarynx 4 .7%TongueTongue 3 .5%Vulva 3 .5%Small Intestine 3 .5%Pleura 3 .5%Other Endocrine 3 .5%Hodgkin’s DiseaseHodgkin’s Disease 3 .5%Mouth, Other Nos 2 .4%HypopharynxHypopharynx 2 .4%Other HematopoieticOther Hematopoietic 2 .4%Other Skin CA 2 .4%Anus 2 .4%Salivary Glands, MajorSalivary Glands, Major 1 .2%Floor Of Mouth 1 .2%OropharynxOropharynx 1 .2%NasopharynxNasopharynx 1 .2%Bile Ducts 1 .2%Nasal Cavity, Sinus, EarNasal Cavity, Sinus, Ear 1 .2%Testis 1 .2%Ureter 1 .2%EyeEye 1 .2%TOTAL 553 100%

1CA Cancer J Clin 2008;58:752American Cancer Society 2008

http://quickfacts.census.govAmerican Cancer Society 2008

http://quickfacts.census.gov2American Cancer Society 20082

% O

f T

OT

al

OT

al

OT

Ca

nC

er C

ase

s

Cancer SiteLung Breast Prostate Colorectal Non-Hodgkins

25%

20%

15%

10%

5%

0%

MHSET, Texas1 & National2 Top Five Site Comparison 2008

MHSETTexas

National

4.7% 4.8%4.6%

13.0%13.5%

8.7%

12.7%12.7%

15.0%15.0%

19.5%

14.414.4%

%

10.4%9.9%

14.3%

StatisticsTotal Number of Cases in Registry 12,475Analytical Cases (diagnosed and/or treated here) 9,826Total Number of Expired Cases 5,226

show that in 2004 17.3% of Angelina County residents were below the poverty level, compared with 16.2% for the state and 12.7% for the nation. Likewise, Angelina County residents have a lower percentage of high school graduates (71.2%) than Texas (75.7%) of the nation as a whole (80.4%). Extrapolating from the above, Angelina County has a population base that is statistically more likely to smoke.

Texas Department of State Health Services. Behavioral Risk Factor Surveillance System, 2006.

Prevalence of Tobacco Use Among Public Middle and High

Texas Youth CDC, National

Health, United States, 2003 With Chartbook on Trends in

Hyattsville, MD: U.S. Department of Health and Human

show that in 2004 17.3% of Angelina County residents were below the poverty level, show that in 2004 17.3% of Angelina County residents were below the poverty level, compared with 16.2% for the state and 12.7% for the nation. Likewise, Angelina County residents have a lower percentage of high school graduates (71.2%) than Texas (75.7%) of the nation as a whole (80.4%). Extrapolating from the above, Angelina County has a population base that is statistically more likely to smoke.

Texas Department of State Health Services. Behavioral Risk Factor Surveillance System, 2006. IITexas

Prevalence of Tobacco Use Among Public Middle and High

Texas Youth CDC, National

Health, United

MHSET Cancer Patient Age at Diagnosis 2008

0 20 40 60 80 100 120 140 160Number of Patients

Age

Ran

ges

10-19

20-29

30-39

40-49

50-59

60-69

70-79

80-89

>99

154

9

2

2

41

98

152

83

12

0 50 100 150 200 250 300 350 400 450 500

WhiteBlack

American IndianAsian Indian/

PakistaniUnknown

MHSET Ethnicity of Cancer Patient Population 2008

88.1 88.1%

10.8%

.7%

.2%

.2%

Chairman’s Report2009 was a year marked by record loss of jobs and a subsequent

staggering loss of health care coverage of many thousands of Americans. It was also a time of great challenge for the community. Despite the difficult period, our physicians and hospital continued to provide quality services to the region. We admire the dedication and the willingness of the health care community to provide exceptional medical care to those in need.

Despite the turbulent times, we have managed nevertheless to achieve several goals. We have implemented the use of NCCN guidelines as a standard for treatment decision making at tumor board conferences and increased our outreach through the ACS Cancer Prevention Study and the African American Outreach Program provided by Women’s Special Services. Moreover, we have implemented new software to maintain accurate and timely follow-up, initiated the utilization of electronic cancer staging forms, and expanded the registry to two personnel. We have recognized the need of cancer patients for rehabilitation services and formed a closer working relationship with our rehab colleagues. More chemotherapy nurses have become oncology certified. And, this year’s Power of Pink!, an annual community breast cancer awareness event, was a great success with an attendance exceeding 650.

We have also made great strides in the surgical arena. Memorial Health System of East Texas is one of the first medical facilities to acquire the da Vinci high definition robotic surgery system. This device has conferred significant benefits to patients in comparison to traditional surgical methods. Robotic procedures are less invasive, resulting in shorter recovery times, smaller incisions, and reduced blood loss. Robotic use is rapidly expanding to include cardiothoracic, urologic, gynecologic, and other surgical procedures.

On the medical oncology front, we have continued our transition from traditional chemotherapy to more targeted therapeutic approaches. The new research in medical oncology has expanded the number and diversity of approaches to the treatment of patients who have had limited success with more conventional treatment modalities. In radiation oncology, we have continued our commitment to provide novel and safer techniques for treatment.

Our efforts were once again rewarded with our being accredited by the American College of Surgeons; we remain the only accredited cancer center in the region. Memorial Health System of East Texas is dedicated to providing prevention, education, and treatment of cancer in a welcoming, comfortable environment. We are committed to our collaborations with other non-profit groups and community outreach programs in order to provide our disadvantaged patients with access to the health care system.

We are seeing a decrease in cancer mortality nationwide for the first time in history. With increased access to care and improved technology for diagnosis, treatment, and supportive care, we are convinced that the future of cancer care is bright.

Munir Ahmad, MDChairman, Cancer CommitteeMemorial Health System of East Texas

MHSET First Course of Treatment 2008

0 50 100 150 200 250 300Number of Patients

Chemo/Hormones

Surgery

Radiation

No Treatment

42.0%

45.9%

25.1%

Trea

tmen

t

34.4%

MHSET Age at Diagnosis 2008

Age at diagnosis ranges from teens to nineties, with the majority of cases diagnosed in patients in their sixties and seventies.

MHSET Ethnicity of Cancer Patient Population 2008

We have seen a rising percentage of African Americans diagnosed with cancer, reflecting greater community awareness of cancer and access to detection and treatment.

MHSET First Course of Treatment 2008

For the 2008 data set of 553 new cases, surgery was a part of the first course of treatment in 45.9% of cases. Radiation therapy and chemotherapy were used 34.4% and 42.0% of cases respectively. Chemotherapy use has continued to rise the last several years, reflecting the development of newer, more effective regimens for both cure and palliation. Hormone therapy continues to be used in about 10% of cases. Most patients receive several different types of treatment, so the percentages overall add up to more than 100%.

In 2008, 25.1% of patients opted for no treatment for their cancer, about the same as 23.3% of patients in 2007. This probably reflects the advanced/incurable stage at presentation of a minority of patients.

Cancer Committee Members 2009

Munir Ahmad, MDChairman

Bramham Reddy, MDCancer Liaison Physician

Sidney C. Roberts, MDRadiation Oncology

Kavitha Pinnamaneni, MDMedical Oncology

Bratcher Runyan, MDGeneral Surgery

Thomas McLaurin, MDDiagnostic Radiology

David Todd, MDPathology

Mariela Vasquez, MDPathology

J. B. Alexander, MDOtolaryngology (ENT)

Samuel Santiago, MDInternal Medicine

Abraham Cheriyan, MDPulmonology

Bryant KrenekPresident & Chief Executive Officer

Les LeachVice President & Chief Operating Officer

Mario Estrella, RNVice President of Patient Services

Kristi GayChief Financial Officer

David HearneChief Compliance Officer

Jennie Ferguson, CPCSDirector of Medical Affairs

Brenda Holbert-Fernandez, FNP-BC, AOCNPCancer Center Nurse Practitioner

Andra Self, BSMT(ASCP), MEd MBA Director of Rehabilitation Services

Jewel Randle, RT(R)(T)Radiation Therapist

Doris Duffield, RNNurse Manager, Renal and Oncology

Cindy Long, RNWomen’s Special Services

Joy RichAmerican Cancer Society Representative

Amy Varnado, LMSWCancer Center Social Worker

Jackie GilmoreCancer Registry Coordinator

Charlotte Wammel, CTRTumor Registrar

Bill MalnarDirector/Imaging Services

Non-Hodgkins Lymphoma Study Non-Hodgkin’s lymphoma is the fifth most common cancer diagnosed in the United States and at MHSET, excluding non-melanoma skin cancers. According to the National Cancer Institute, an estimated 65,980 new cases of non-Hodgkin’s lymphoma will be diagnosed in the United States in 2009. Of those, it is estimated that 19,500 will die. Non-Hodgkin’s lymphoma is cancer that starts in lymphoid, or lymphatic, tissue. The lymph system is a complex network of cells and channels that runs throughout the body and defends against disease and infection. Most of the time, lymphomas arise in bean-shaped structures called lymph nodes. Lymphomas start from lymphocytes in either lymph nodes or other sites of lymphoid tissue, such as the bone marrow, and may spread from there. The two main types of lymphocytes are B lymphocytes (B cells) or T lymphocytes (T cells). B-cell lymphomas account for 85% of non-Hodgkin’s lymphoma and T-cell lymphomas make up about 15%. Non-Hodgkin’s lymphoma tend to progress in a non-systematic and unpredictable manner. These lymphomas are categorized into follicular or diffuse types depending on the growth pattern within the lymph node when viewed under a microscope. Follicular lymphomas are clumped together similar to the normal follicle pattern seen in lymph nodes. The average age of someone with this type is 60 years old. This is considered a slow-growing cancer, but in advanced stages it is usually not considered curable by standard treatment. Five-year survival after diagnosis is about 60-70%. Over time, follicular lymphomas can transform into the faster growing diffuse large B-cell lymphoma. Diffuse large B-cell lymphoma makes up about 31% of all lymphomas. It is a fast-growing disease that usually presents with a rapidly growing mass in the body or in a lymph node that can be felt by the patient. One-third of these lymphomas are confined to one part of the body. When localized, it is considered to be more curable than when it has spread to other parts of the body. It can arise in any age group, but the average age at diagnosis is in the mid-60s. The cure rate tends to be about 40-50%. Some of the less common non-Hodgkin’s lymphomas are MALT lymphoma, Mantle cell lymphoma, Burkitt’s lymphoma, AIDS-related B-cell lymphoma, primary CNS lymphoma and T-cell lymphomas. The most aggressive types of lymphoma are Burkitt’s lymphoma, lymphoblastic lymphoma, and AIDS-related lymphoma. The most common symptoms with non-Hodgkin’s lymphoma are swollen glands in the neck, armpits, or groin. The enlarged lymph nodes are usually painless and do not respond to antibiotics. Other symptoms can include loss of appetite, weight loss, nausea, vomiting, abdominal pain, back pressure, itching, bone pain, headaches, constant coughing, abnormal pressure and congestion in face, neck, and upper chest. Fatigue, weakness, flu-like symptoms, fever and night sweats may occur. A person should seek medical care if they experience any of these symptoms for more than two weeks. On physical exam, a physician may find enlarged lymph nodes or an enlarged spleen or liver. Further work-up with a biopsy and diagnostic x-rays would be expected. From 1998-2001, there were 51 cases of non-Hodgkin’s lymphoma diagnosed and/or treated at Memorial Health System of East Texas. Age at diagnosis ranged from 20s to 90s, with the average age in the 60s and 70s, as expected. Stage at diagnosis is weighted toward stage IV, typical for this disease. Our survival data compares quite favorably with regional and national data published on the American College of Surgeons website, reflecting the quality of care delivered locally.

15

10

5

0

20’s 30’s 40’s 50’s 60’s 70’s 80’s 90’s

1

34

9

11

14

6

3

30

20

10

0Stage I Stage II Stage III Stage IV

109

5

27

1 year 2 year 3 year 4 year 5 year

80

70

60

50

40

30

20

10

0

Perc

ent

Stage IV Survival

MHSET Regional National

100

80

60

40

20

01 year 2 years 3 years 4 years 5 years

Years of Survival

Perc

ent o

f Pat

ient

Sur

viva

l

MHSET Regional National

Non-Hodkin’s Lymphoma 5 Year SurvivalAll Stages Combined (1998-2001)

memorialhealth.org

Arthur Temple Sr. Regional Cancer Center Report to the Community 2009

Cover photo by Joe Lowery Photography