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Adult Oncology Services

Introduction

The Siteman Cancer Center treats patients with all types of cancer through 12 multidisciplinary care centers, but has gained national recognition for clinical programs in leukemia and lymphoma as well as breast, gastrointestinal, head and neck, and genitourinary cancers. A patient-centered approach to care is reinforced by programs such as the new Patient Navigator Service, which provides volunteers who greet new patients on the day of their first appointment, give a brief orientation, and serve as an escort to physician offices and testing locations.

General Information

General Information

800.600.3606

www.siteman.wustl.edu

Referring Physician / Self-Referral Line

877.251.6485

Clinical Trials Information

www.siteman.wustl.edu/findprotocol.aspx

Location

St. Louis, MO

Facility

Siteman Cancer Center's main campus is located on the Washington University Medical Center complex in the Central West End area of St. Louis.

Outpatient services are provided in the Center for Advanced Medicine, which houses physician offices, a chemotherapy center, radiation oncology facilities, radiology facilities, and laboratory testing areas in one location for patient convenience. In addition, the Center for Advanced Medicine contains the Barnard Health and Cancer Information Center, which offers education and support programs, conference facilities, a coffee bar, a gift shop, and a pharmacy.

Patients who require hospitalization are admitted to Barnes-Jewish Hospital, also located on the Washington University Medical Center campus. Dedicated areas for cancer patients within the hospital include a leukemia and lymphoma unit; a bone marrow and stem cell transplant unit; a gynecologic oncology unit; a unit for patients over age 65; and a general oncology unit.

In addition to our main campus, Siteman operates outpatient facilities in Creve Coeur, Mo., and St. Peters, Mo.

Laboratory space for the more than 250 research members of the cancer center is located on the Washington University Medical Center campus. State-of-the-art research facilities include Washington University's world-renowned Genome Center and a Good Manufacturing Practice laboratory for the production of cellular and biological products that is one of the largest facilities of its type at a U.S. academic medical center.

Travel Assistance

Staff members in Barnes-Jewish Hospital's Guest and Patient Relations Department can provide information about traveling to the Siteman Cancer Center. For more information, call 800.451.4892.

Lodging

Low- or no-cost lodging for patients and families is available at several facilities near the main Siteman campus. Referral by a physician, social worker, or nurse coordinator may be required. In addition, reduced rates for patients are offered at many nearby hotels and motels, including the Parkway Hotel, which is connected to the cancer center via an enclosed walkway. For more information about lodging options, call 800.551.3492.

Treatment

Multidisciplinary Clinics

The faculty of the Siteman Cancer Center provide disease-specific, multi-disciplinary care utilizing a broad array of clinical care options. Multi-disciplinary teams are developed to be specific to the disease being treated. Most oncology patients receive their outpatient care in the outpatient facility of the Siteman Cancer Center, located in the Center for Advanced Medicine on the Washington University Medical Center campus. All diagnostic and treatment-related care is provided in a single location within this building. For the convenience of patients living within the St. Louis metropolitan area, the Siteman Cancer Center has also established two community-based programs bearing the Siteman name, one in west St. Louis County at Barnes-Jewish West County Hospital and the second in St. Peters, Mo., at Barnes-Jewish St. Peters Hospital. New patient appointments are coordinated to ensure that all physicians a newly diagnosed patient might need to see in order to establish an appropriate treatment plan happen within a single day, thereby minimizing the travel needs of patients and providing prompt recommendations for treatment planning.

All of the following disease centers can be reached by calling 800.600.3606.

Breast Cancer

Lung Cancer

Upper Gastronintestinal Cancer-Includes esophageal, stomach, pancreas, gallbladder, liver cancers

Lower Gastrointestinal Cancer-Includes colon and rectal cancers

Urologic Cancer

Neuro Oncology

Head and Neck Cancer

Gynecologic Cancer

Sarcoma and Soft Tissue

Endocrine Cancer-Includes thyroid cancer

Hematologic Malignancies-Includes leukemia, multiple myeloma, myleodysplastic syndromes, aplastic anemia, lymphomas

Transplant Programs

The Bone Marrow and Stem Cell Transplant Program at the Siteman Cancer Center is consistently ranked as one of the top five transplant centers in the world based on volume of transplants performed each year. The program offers expertise in the treatment of pre-leukemia and acute leukemia. In addition, a high volume of patients receive treatment for multiple myeloma. The service consistently has over 40 open transplant-specific clinical trials.

A comprehensive patient evaluation and treatment planning process has also been nationally recognized as a "best practice." Since 1975, over 3,000 patients have been transplanted at the center. The annual number of transplants exceeds 300, fairly evenly divided between autologous and allogeneic transplants. Approximately half of the allogeneic volume is composed of patients requiring matched unrelated donor transplants. A 26-bed inpatient unit provides acute and critical care for transplant patients, and a newly established 38-bed hematologic unit provides care for patients diagnosed with leukemia or who require care for lymphoma and other blood-related cancers. Patient care is delivered in a structured, patient-focused manner.

In addition to comprehensive clinical care, the tradition of focused translational research in the area of understanding the development of acute leukemia has been supported by a National Cancer Institute Program Project Grant (P01) titled "Genomics of Acute Myeloid Leukemia." As a result of this grant, a large clinical and genetic tumor bank has been established to study all of the mutations associated with acute myelogenous leukemia with the intent of designing new therapeutic targets in the future.

Complementary and Alternative Medicine

The Siteman Cancer Center offers an array of supportive services to complement a patient's treatment plan. Such services include a comprehensive nutritional counseling service, which provides support to inpatients and outpatients, and massage therapy. A wide variety of course offerings allow patients to learn about the benefits of exercise, relaxation, and self-expression through art as part of their cancer treatment.

Cancer Prevention and Screening

The Siteman Cancer Center is recognized as a community leader in offering cancer risk-reduction initiatives and cancer screenings. A comprehensive community outreach program provides more than 200 community offerings and 30 continuing medical education (CME) activities to the entire geographic area, regardless of a participant's ability to pay. Over 30,000 people participate in these structured sessions each year. In addition, the Siteman Cancer Center partners with public school systems to establish anti-smoking initiatives. Prior to the development of the Siteman Cancer Center, Barnes-Jewish Hospital's Breast Health Center established, through the Mallinkrodt Institute of Radiology, the first mobile mammography van west of the Mississippi River. Since that time, the van has grown to serve both corporate clients and underserved communities in the metropolitan St. Louis area and the rural Missouri "bootheel" area. Both of these areas are known to have a higher incidence of breast cancer development than the general population of Missouri. In 2007, the mobile mammography program served over 7,000 women. In the fall of 2006, the screening and diagnostic mammography services for the Siteman Cancer Center was the first in the Midwest to convert to total full-field digital mammography equipment.

As a result of the infrastructure established for cancer screenings, the Siteman Cancer Center was recognized by the state of Missouri and selected as one of the sites for Show-Me Healthy Missouri, which provides financial support for women being screened for cervical and breast cancer. The program was recently expanded to include support for colorectal cancer screening. The Siteman Cancer Center has always been the leading provider of services for these state-based programs. As a result of this success, legislation passed by the state mandates that women who are diagnosed through these programs be automatically covered through Missouri Medicaid, thereby relieving them from the burden of financing treatment.

The Siteman Cancer Center holds an NCI Center of Excellence in Cancer Communications Research (P50) grant. Collaborations have been established to focus patient education material development on targeted messages that might better influence health behavior changes. St. Louis remains the third-largest refugee resettlement center in the country. This has allowed the Siteman Cancer Center to gain added experience in developing culturally competent programs and services.

A number of initiatives are moving forward related to cancer prevention:

The Prevention and Control Research Program aims to develop, advance, and evaluate improved interventions in smoking prevention and cessation, early detection, epidemiology, cancer communication and interventions, psychosocial aspects of care, and chemoprevention. A key theme in the program (including research on interventions to prevent cancer and enhance cancer care) is dissemination to low-income and minority groups that suffer disproportionate cancer burden. The program received a Community Networks Program U01 grant in 2005 for the Program for the Elimination of Cancer Disparities (PECaD), which addresses disparities in care, outreach, education, training, and research with a particular focus on African Americans, the largest minority group in the St. Louis region.

The Chemoprevention Focus Group works to identify and test improved agents that prevent the development or recurrence of cancer in people at risk. This work is based on fundamental plant science and other basic science approaches, building on unique collaborations with the renowned Missouri Botanical Garden and the Donald Danforth Plant Science Center. Experts in the basic sciences have worked to develop new chemopreventive agents for use in animal and then human trials.

Support Services

The Siteman Cancer Center offers a wide array of support services for cancer patients and their families from initial diagnosis through survivorship. Such services include the new Patient Navigator Program, in which a patient is linked with a Siteman Cancer Center volunteer who escorts them to all of their physician and laboratory visits during their first time at the center. A variety of "patient navigation" services are provided to aid patients through their treatment plan based on their diagnosis. Classes developed in response to the needs of cancer patients and their families are provided in easily accessed forums throughout the week. Structured support groups are in place for women with breast cancer, family members of bone marrow and stem cell transplant patients, women who are being treated/have been treated for gynecological cancers, and young adults with cancer. Plans are being developed to establish education and support services for caregivers of loved ones going through cancer treatment.

The Siteman Cancer Center provides nutritional counseling for inpatients and outpatients, and psychosocial support services are also provided through social workers, psychologists, and psychiatry consultation.

A comprehensive cancer resource center, the Barnard Health and Cancer Information Center is located in the same building where cancer patients come for treatment. The center provides written materials, videos, and assistance with internet searches for cancer patients and their families. It is staffed with nurses who can provide additional information and support to patients and families, linking them to appropriate resources. It also provides items for uninsured and underinsured women, including breast prostheses, bras for women who have had mastectomies, and wigs for women with hair loss related to treatment. All patients are provided with a hat or turban. In addition, the Arts as Healing Program offers a variety of ways for cancer patients to express themselves through the arts. This includes several painting classes and projects, creative writing opportunities, and even the chance to give back by making turbans for other patients.

Supportive Care

Pain Service

Siteman Cancer Center patients benefit from access to the Pain Management Program. Using a muti-modality approach, the Pain Management Program seeks to tailor treatment plans for acute and chronic cancer pain to the unique needs of the patient.

Palliative/Supportive Service

An inpatient consultation service for palliative care was established in 2005. Patients and families benefit from the strong relationship established between this service and the primary oncology team.

Home Care/Hospice Service

BJC HealthCare provides comprehensive home care, supportive care, and hospice services. In the event patients reside outside the service area covered by the program, BJC Home Care and BJC Hospice coordinate referrals for patients needing services in outlying areas.

Nutrition Service

Registered dietitians are available to establish specific nutritional plans that are unique to patients, their disease and their treatment plan.

Cooperative Group Membership

Cooperative Group Membership List

ACOSOG

AMC

ACRIN

BMT CTN

CALGB

GOG

RTOG

Activities in Cooperative Group

Study Chairs, Committee/Cadre Membership and Chairs, active participation in disease committees

Adult Oncology Program-2006

No. of Inpatient Beds

(Medical/Surgical)

No. of Admissions

Average Length of Stay (days)

No. of New Outpatients

No. of Oncologists (Medical/Surgical)

236

7,735

6.44

9,746*

53

*Total of outpatient oncology visits of 92,267