Annual Report. Cape Cod Hospital and Falmouth Hospital Regional Cancer Network Expert physicians. Quality hospitals. Superior care.

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1 Annual Report Cape Cod Hospital and Falmouth Hospital Regional Cancer Network 2014 Expert physicians. Quality hospitals. Superior care.

2 Cape Cod Hospital s Davenport- Mugar Hematology/Oncology Center and Falmouth Hospital s Clark Cancer Center are multidisciplinary cancer centers located on Cape Cod in Massachusetts.

3 Letter from CCHC MEDICAL ONCOLOGY When I started in this field I joined a research group that focused on treating cancer in a targeted way with proteins called monoclonal antibodies. Many of my older colleagues weren t inspired by the concept. Chemotherapy, they said is the only way to treat cancer. Fast forward 25 years and lo and behold the target and personalized approach to cancer treatment has become one of the bedrocks on which we practice. We target specific proteins on and inside cancer cells and disable them. We manipulate the immune system, previously complicit in allowing cancers to take hold, and force it to act in a way that it is supposed to; that is force it to attack what is, in essence, a foreign invader. Chemotherapy is still an important tool but these new therapies are revolutionizing the way we treat cancer. The list of malignancies that we are making progress toward treating in this manner is growing seemingly weekly. The progress we are making in medicine allows us to treat patients in a whole new way and will continue to evolve as long as cancer exists. We live down the road from Boston so we are blessed to have access to some of the most up to date research facilities. At Cape Cod Healthcare Regional Cancer Network (CCHCRN), we encourage second opinions and have partnered with specialists from Dana-Farber Cancer Institute and Massachusetts General Hospital who come to our Hyannis facility and see patients who are seeking those second opinions. We believe in collaborations with our Boston colleagues so even if they aren t on site, we reach out to them by phone. At CCHCRN, we are able to provide excellent care right here for our patients so they don t have to drive to Boston on a regular basis. And we ll treat them with passion because after all, they are our friends and neighbors. The passage on the following page is one that I found as I was starting out as a young physician. It was published in the Journal of the American Medical Association. It was written by a pediatric oncologist Michael Radetsky, MD. He describes a father trying to coax a smile out of his dying son by waving a toy dragon in front of his face. It inspired me then and I still turn to it on occasion when I want to remind myself of the nobility in our profession. EXPERT PHYSICIANS. QUALITY HOSPITALS. SUPERIOR CARE. 1

4 What fulfills the caregiver? Certainly, the diagnostic challenge, the altruistic glow, the grateful thanks all provide a measure of satisfaction. But more than all of that, fulfillment comes from the sudden intimacies with relative strangers. Those moments when the human barrier cracks open to reveal what is most secret and inarticulate. Illness strips away superficiality to reveal reality in etched detail. This revelation can fuse together disparate lives in unexpected kinship. Is it the fear of death, the dreaded pain, the sorrow, or the loss? The caregiver who can see is there to share in it. Who else so often listens to the whispered thought, holds the hand, puzzles over the vagaries of fate, and feels another s moment so personally and powerfully? And who else has such a chance to realize that it matters less whether a moment is one of supreme sadness or supreme joy than it does that the moment itself is supreme? This is the caregiver s privilege: to be lifted out of the dross of common days in order to experience such clarity of feeling. The intensity of birth and death, pleasure and sorrow as expressed in the lives of others has the power to nullify personal boundaries in sudden communion. Then, the world is seen in its proper proportions, and the tenuous miracle of existence is underscored. Surely, it must profit us to feel this deeply, with the hope that somehow, in the sweep of that feeling, we might yet learn to appreciate the wondrous happenings of our own lives. As we move forward in this exciting age, it is gratifying to know that the leadership at Cape Cod Healthcare is committed to bringing the best in cancer care to our community. Together, we are doing our part to make sure that Cape Cod s cancer patients are given the best opportunities to fight this dreaded disease. Dave Lovett, MD Medical Oncology at Cape Cod Hospital 2 Cape Cod Healthcare Regional Cancer Network 2014

5 Cancer Care CAPE COD HOSPITAL The Cancer Program at Cape Cod Hospital is accredited as a Community Comprehensive Program by the American College of Surgeons. The Cuda Women s Health Center at the Wilkens Outpatient Medical Complex is also accredited by the National Accreditation Program for Breast Centers, which is part of the American College of Surgeons and The American College of Radiology. These programs provide multimodality care plans for cancer patients as outlined by national standards of care such as the National Comprehensive Cancer Network (NCCN), American College of Radiology (ACR), American College of Surgeons (ACOS) and College of American Pathologists (CAP). Our staff of dedicated board certified medical and radiation oncologists, as well as nursing, pharmacy, technical, social work, tumor registry, and clerical staff and volunteers provide state-of-the-art care in a bright and emotionally supportive atmosphere. In addition, we have long-standing collaborative relationships with local surgeons, gynecologists, urologists, dermatologists, pathologists, and radiologists. We are affiliated with many distinguished cancer treatment centers and organizations, including the National Cancer Institute, Dana-Farber/Partners Cancer Care, the Dana-Farber Cancer Institute, Brigham and Women s Hospital and Massachusetts General Hospital, through their adult oncology collaboration. CAPE COD HOSPITAL CANCER CENTER S TOP FIVE TREATMENT AREAS In 2014, there were 1,162 analytic patients treated at the CCH Cancer Center. BREAST 26% OTHER 37% LUNG 14% PROSTATE 9% COLORECTAL 7% BLADDER 7% EXPERT PHYSICIANS. QUALITY HOSPITALS. SUPERIOR CARE. 3

6 Some of the benefits of our affiliations include: Multidisciplinary conferences to review cases prospectively Monthly second opinion specialty clinics on site with Dana-Farber Cancer Institute physicians Collaboration to determine best treatment plans Access to up-to-date pharmaceutical options and nursing standards Clinical staff participation in networking conferences and grand rounds Participation in clinical trials for new treatments Cape Cod Hospital has a vigorous clinical trial program with access to National Study Groups protocols and the Dana-Farber Cancer Institute. The Davenport-Mugar Hematology/Oncology Center works closely with our local American Cancer Society chapter to ensure our patients have access to and benefit from their many programs and support systems. 4 Cape Cod Healthcare Regional Cancer Network 2014

7 CAPE COD HOSPITAL 2014 PRIMARY TREATMENT AREAS TOTAL MALE FEMALE # % # % # % ORAL CAVITY & PHARYNX % % 8 1.2% Tongue % 9 1.6% 3 0.5% Salivary Glands 2 0.2% 0 0.0% 2 0.3% Floor of Mouth 2 0.2% 0 0.0% 2 0.3% Gum & Other Mouth 6 0.5% 5 0.9% 1 0.2% Tonsil 6 0.5% 6 1.1% 0 0.0% Oropharynx 2 0.2% 2 0.4% 0 0.0% Hypopharynx 5 0.4% 5 0.9% 0 0.0% DIGESTIVE SYSTEM % % % Esophagus % % 7 1.1% Stomach % 8 1.4% 8 1.2% Small Intestine 2 0.2% 0 0.0% 2 0.3% Colon Excluding Rectum % % % Cecum Appendix Ascending Colon Hepatic Flexure Transverse Colon Splendic Flexure Descending Colon Sigmoid Colon Large Intestine, NOS Rectum & Rectosigmoid % % % Rectosigmoid Junction Rectum Anus, Anal Canal & Anorectum % 5 0.9% 7 1.1% Liver & Intrahepatic Bile Duct 9 0.7% 7 1.3% 2 0.3% Liver Intrahepatic Bile Duct Gall Bladder 1 0.1% 0 0.4% 1 0.6% Other Biliary 1 0.1% 0 0.0% 1 0.2% EXPERT PHYSICIANS. QUALITY HOSPITALS. SUPERIOR CARE. 5

8 TOTAL MALE FEMALE # % # % # % Pancreas % % % Peritoneum, Omentum, Mesenterm 4 0.3% 0 0.0% 4 0.6% Other Digestive Organs 3 0.2% 1 0.2% 2 0.3% RESPIRATORY SYSTEM % % % Nose, Nasal Cavity & Middle Ear 3 0.2% 2 0.4% 1 0.2% Larynx % % 1 0.2% Lung & Bronchus % % % BONES & JOINTS 1 0.1% 1 0.2% 0 0.0% Bones & Joints 1 0.1% 1 0.2% 0 0.0% SOFT TISSUE 5 0.4% 1 0.2% 4 0.6% Soft Tissue (including Heart) 5 0.4% 1 0.2% 4 0.6% SKIN EXCLUDING BASAL & SQUAMOUS % % % Melanoma Skin % % % Other Non-Epithelial Skin 2 0.2% 0 0.0% 2 0.3% BREAST % 1 0.2% % Breast % 1 0.2% % FEMALE GENITAL SYSTEM % 0 0.0% % Corpus & Uterus, NOS % 0 0.0% % Ovary % 0 0.0% % Vagina 2 0.2% 0 0.0% 2 0.3% Vulva 1 0.1% 0 0.0% 1 0.2% Other Female Genital Organs 1 0.1% 0 0.0% 1 0.2% MALE GENITAL SYSTEM % % 0 0.0% Prostate % % 0 0.0% Testis 3 0.2% 3 0.5% 0 0.0% Penis 2 0.2% 2 0.4% 0 0.0% URINARY SYSTEM % % % Urinary Bladder % % % Kidney & Renal Pelvis % % 7 1.1% Ureter 4 0.3% 4 0.7% 0 0.0% Other Urinary Organs 1 0.1% 1 0.2% 0 0.0% BRAIN & OTHER NERVOUS SYSTEM % % % Brain % % 7 1.1% Cranial Nerves Other Nervous System 4 0.3% 1 0.2% 3 0.5% ENDOCRINE SYSTEM % 1 0.2% % Thyroid % 1 0.2% % 6 Cape Cod Healthcare Regional Cancer Network 2014

9 TOTAL MALE FEMALE # % # % # % LYMPHOMA % % % Hodgkin Lymphoma 2 0.2% 1 0.2% 1 0.2% Non-Hodgkin Lymphoma % % % NHL Nodal NHL Extranodal MYELOMA % % 6 0.9% Myeloma % % 6 0.9% LEUKEMIA % % % Lymphocytic Leukemia % % 8 1.2% Chronic Lymphocytic Leukemia Other Lymphocytic Leukemia Myeloid & Monocytic Leukemia % 8 1.4% 4 0.6% Acute Myeloid Leukemia Chronic Myeloid Leukemia Other Leukemia 1 0.1% 0 0.0% 1 02% MESOTHELIOMA 5 0.4% 5 0.9% 0 0.0% Mesothelioma 5 0.4% 5 0.9% 0 0.0% KAPOSI SARCOMA 1 0.1% 1 0.2% 0 0.0% Kaposi Sarcoma 1 0.1% 1 0.2% 0 0.0% MISCELLANEOUS % % % Miscellaneous % % % TOTAL 1, TREATMENT AREAS BY GENDER MALE # % PROSTATE % LUNG & BRONCHUS 89 16% URINARY BLADDER 64 11% COLON & RECTUM 46 8% NON-HODGKIN LYMPHOMA 34 6% MELANOMA OF THE SKIN 28 5% ORAL CAVITY & PHARYNX 27 5% LEUKEMIA 20 4% PANCREAS 15 3% KIDNEY & RENAL PELVIS 12 2% FEMALE # % BREAST % LUNG & BRONCHUS 82 13% COLON & RECTUM 39 6% UTERINE CORPUS 24 4% MELANOMA OF THE SKIN 16 2% NON-HODGKIN LYMPHOMA 14 2% LEUKEMIA 13 2% OVARY 11 2% THYROID 10 2% KIDNEY & RENAL PELVIS 7 1% ALL OTHER SITES % ALL OTHER SITES % EXPERT PHYSICIANS. QUALITY HOSPITALS. SUPERIOR CARE. 7

10 Cancer Care FALMOUTH HOSPITAL The Falmouth Hospital Cancer Program is accredited as a Community Program by the American College of Surgeons. The Breast Cancer program at the Seifer Womens Health and Imaging Center is accredited by the National Accreditation Program for Breast Centers, a division of the American College of Surgeons, as well as the American College of Radiology. These programs provide multimodality care plans for cancer patients as outlined by national standards of care such as the National Comprehensive Cancer Network (NCCN), the American College of Radiology (ACR), the American College of Surgeons (ACOS), and the College of American Pathologists (CAP). In summary, the Falmouth Hospital Cancer Program offers a full-range of comprehensive medical and surgical specialists who are board certified and work in collaboration to bring personalized, compassionate care to patients. Radiation Therapy consultations and treatments are offered at the Clark Cancer Center in the Falmouth Hospital Medical Office Building. Medical Oncology/Hematology consultations and treatments are offered at the Hematology Oncology Specialists of Cape Cod in North Falmouth. Our clinicians offer interactive consultations on a regular basis, jointly review test results, and work in partnership on treatment plans. We hold weekly tumor conferences which enable our physicians to share information on both complex and common diagnoses and plan the best therapies for patients. Our focus of care is to treat the whole patient by understanding the emotional and physical effects of cancer which our patients experience. To augment this care, Falmouth Hospital has assembled strong support teams who address such issues as pain management, palliative medicine, physical therapy, and social services among others. We initiate numerous screening programs in our community outreach efforts. A recent example includes our low-dose lung screening program that has just been activated. Our belief in a comprehensive cancer program that addresses the individual patient is evident in the exceptional care we provide our patients each day. 8 Cape Cod Healthcare Regional Cancer Network 2014

11 Our data is reported to the Massachusetts Cancer Registry as required by state law, as well as the National Cancer Data Base (NCDB) which allows comparison with local, state and national statistics. During 2014, a total of 415 cases were entered into the Cancer Registry of which 324(78%) were analytic and 91(22%) were non-analytic. Of the 324 analytic cases, 149 were male and 175 were female. The five major sites continue to be breast, lung, colorectal, bladder, and prostate. There were 77 cases of breast cancer diagnosed which accounts for 24% of the total number of analytic cases in or 61% of these cases were diagnosed with stage 0 and stage 1 disease. Of note: in comparing the years of 2008, 2009, 2010, 2011, and 2012, there was a steady increase in class 0 cases, which were cases diagnosed at Falmouth and treated elsewhere. However, in 2012 and 2013, class 0 cases decreased but were back up in number in 2014, and were 31% of the total analytic cases increasing from 21 % in FALMOUTH HOSPITAL CANCER CENTER S TOP FIVE TREATMENT AREAS In 2014, there were 337 analytic patients treated at Falmouth Hospital s Cancer Center. BREAST 25% OTHER 34% LUNG 14% COLORECTAL 12% PROSTATE 9% BLADDER 6% EXPERT PHYSICIANS. QUALITY HOSPITALS. SUPERIOR CARE. 9

12 2013. Colorectal cancer accounted for the third highest incidence of cancer for both sexes with a total of 41 cases or 13% of the total cases. There were 19 males and 22 females. 71% of these colorectal patients were diagnosed with stage 2 and 3 disease, dramatically up from 2013, which had 23 percent of cases with stage 2 and 3 disease. Lung cancer incidence increased from 14 percent of analytic cases in 2014 from 10 percent in There were 31 cases diagnosed in 2013 and 46 in Could this have something to do with our program of low-dose lung screening? We saw a slight increase in prostate cancers from 23 cases to 28 analytic cases. There still are a significant number of non-analytic cases who go elsewhere for treatment. In 2014, 9 patients went elsewhere or 9 percent of class 0 cases, but in 2013, 8 patients went elsewhere, or 11 percent of class 0 cases. We are seeing less prostate cases in this class 0 category, down from 35 percent in However, we still believe that a good portion of prostate cancer cases on the Cape never are diagnosed or treated in our system. The bladder cancer rates have stayed consistent throughout the years. There is, however, a slight decrease in bladder cases in 2014 from 2013, 10 cases in all. 10 Cape Cod Healthcare Regional Cancer Network 2014

13 FALMOUTH HOSPITAL 2014 PRIMARY TREATMENT AREAS TOTAL MALE FEMALE # % # % # % ORAL CAVITY & PHARYNX % % 2 1.1% Tongue 2 0.6% 1 0.7% 1 0.6% Salivary Glands 1 0.3% 0 0.0% 1 0.6% Gum & Other Mouth 1 0.3% 1 0.7% 0 0.0% Tonsil 5 1.5% 5 3.3% 0 0.0% Dropharynx 1 0.3% 1 0.7% 0 0.0% Hypopharynx 2 0.6% 2 1.3% 0 0.0% DIGESTIVE SYSTEM % % % Esophagus 3 0.9% 3 2.0% 0 0.0% Stomach 9 2.7% 6 3.9% 3 1.7% Small Intestine 4 1.2% 3 2.0% 1 0.6% Colon Excluding Rectum % % % Cecum Ascending Colon Hepatic Flexure Transverse Colon Splenic Flexure Descending Colon Sigmoid Colon Rectum & Rectosigmoid % 6 3.9% 8 4.5% Rectosigmoid Junction Rectum Anus, Anal Canal & Anorectum 2 0.6% 0 0.0% 2 1.1% Liver & Intrahepatic Bile Duct 6 1.8% 4 2.6% 2 1.1% Gallbladder 2 0.6% 0 0.0% 2 1.1% Other Biliary 2 0.6% 1 0.7% 1 0.6% Pancreas 5 1.5% 4 2.6% 1 0.6% EXPERT PHYSICIANS. QUALITY HOSPITALS. SUPERIOR CARE. 11

14 TOTAL MALE FEMALE # % # % # % RESPIRATORY SYSTEM % % % Nose, Nasal Cavity & Middle Ear 1 0.3% 1 0.7% 0 0.0% Larynx 5 1.5% 4 2.6% 1 0.6% Lung & Bronchus % % % SOFT TISSUE 2 0.6% 0 0.0% 2 1.1% Soft Tissue (including Heart) 2 0.6% 0 0.0% 2 1.1% SKIN EXCLUDING BASAL & SQUAMOUS % 7 4.6% 9 5.1% Melanoma Skin % 7 4.6% 7 4.0% Other Non-Epithelial Skin 2 0.6% 0 0.0% 2 1.1% BREAST % 0 0.0% % Breast % 0 0.0% % FEMALE GENITAL SYSTEM % 0 0.0% % Cervix Uteri 3 0.9% 0 0.0% 3 1.7% Corpus & Uterus, NOS % 0 0.0% % Ovary 2 0.6% 0 0.0% 2 1.1% Vulva 2 0.6% 0 0.0% 2 1.1% MALE GENITAL SYSTEM % % 0 0.0% Prostate % % 0 0.0% Testis 3 0.9% 3 2.0% 0 0.0% URINARY SYSTEM % % 3 1.7% Urinary Bladder % % 2 1.1% Kidney & Renal Pelvis 3 0.9% 2 1.3% 1 0.6% BRAIN & OTHER NERVOUS SYSTEM 1 0.3% 1 0.7% 0 0.0% Brain 1 0.3% 1 0.7% 0 0.0% ENDOCRINE SYSTEM 1 0.3% 0 0.0% 1 0.6% Thyroid 1 0.3% 0 0.0% 1 0.6% LYMPHOMA % 7 4.6% 3 1.7% Non-Hodgkin Lymphoma % 7 4.6% 3 1.7% NHL Nodal NHL Extranodal Cape Cod Healthcare Regional Cancer Network 2014

15 TOTAL MALE FEMALE # % # % # % MYELOMA 2 0.6% 2 1.3% 0 0.0% Myeloma 2 0.6% 2 1.3% 0 0.0% LEUKEMIA 2 0.6% 1 0.7% 1 0.6% Lymphocytic Leukemia 2 0.6% 1 0.7% 1 0.6% MISCELLANEOUS 4 1.2% 1 0.7% 3 1.7% Miscellaneous 4 1.2% 1 0.7% 3 1.7% TOTAL TREATMENT AREAS BY GENDER MALE # % PROSTATE 28 18% LUNG & BRONCHUS 26 17% URINARY BLADDER 19 13% ORAL CAVITY & PHARYNX 10 7% NON-HODGKIN LYMPHOMA 7 5% MELANOMA OF THE SKIN 7 5% PANCREAS 4 3% KIDNEY & RENAL PELVIS 2 1% LEUKEMIA 1 1% FEMALE # % BREAST 77 44% COLON & RECTUM 22 12% LUNG & BRONCHUS 21 12% UTERINE CORPUS 13 7% MELANOMA OF THE SKIN 7 4% NON-HODGKIN LYMPHOMA 3 2% OVARY 2 1% KIDNEY & RENAL PELVIS 1 1% THYROID 1 1% LEUKEMIA 1 1% ALL OTHER SITES 29 19% ALL OTHER SITES 29 16% EXPERT PHYSICIANS. QUALITY HOSPITALS. SUPERIOR CARE. 13

16 The Cape Cod and Falmouth Hospitals Cancer Programs are proud to provide the following support & patient services: CLINICAL RESEARCH If you ve been diagnosed with cancer, you ll be reassured to know that the skills and technology found in the most advanced cancer institutions in the nation are available right here on the Cape. And you ll benefit from the things that set us apart, like personalized care from specialists who know you by name and our clinical partnership with the Dana-Farber/Partners Cancer Care (DF/PCC) for research trials, consultations and second opinions. At CCHCRN, we have many trials available for different types of cancer. The studies are sponsored by DF/PCC, national co-operative groups or industry groups. All patients enrolled in studies are overseen by a certified oncology research nurse in addition to the principal investigator. SOCIAL WORK The experience of having a cancer diagnosis is one that is fraught with difficult thoughts, feelings and challenges. This often translates into a feeling of distress. Distress has been defined as an unpleasant experience of an emotional, psychological, social, or spiritual nature that interferes with the ability to cope with cancer treatment. It extends along a continuum, from common normal feelings of vulnerability, sadness, and fears, to problems that are disabling, such as true depression, anxiety, panic, and feeling isolated or in a spiritual crisis. National Cancer Institute. Oncology Social Workers are uniquely able to evaluate people with cancer and then help them to develop positive coping mechanisms, locate resources and become educated about the illness. They also assist with important discussions about treatment decisions, end of life planning and how to communicate with partners, family, friends and the community at large. They are strong advocates for people when they have difficulty in negotiating the large and complex systems such as health care and health insurance. 14 Cape Cod Healthcare Regional Cancer Network 2014

17 Professional Oncology Social Work Services are provided to the members of the Cape Cod Community by a dedicated team of masters prepared Social Workers. These LICSW s provide services in the Mugar Davenport Cancer Center at Cape Cod Hospital in Hyannis as well as in the Clark Cancer Center on the grounds of the Falmouth Hospital. The types of services provided include supportive counseling, problem solving, education and referrals to a myriad of resources. Resources include transportation, food, financial, housing, health insurance, durable medical equipment. SURVIVORSHIP In cancer, survivorship focuses on the health and life of a person with cancer post treatment until the end of life. It covers the physical, psychosocial, and economic issues of cancer, beyond the diagnosis and treatment phases. Survivorship includes issues related to the ability to get health care and follow-up treatment, late effects of treatment, second cancers, and quality of life. Family members, friends, and caregivers are also considered part of the survivorship experience. National Cancer Institute Cape Cod Healthcare provides an integrated approach to survivorship by utilizing the expertise of the Survivorship Program Manager to address issues of health care access, follow up treatment access, coping with the late effects of treatment and the impact on quality of life. The Survivorship Program Manager is an Oncology Certified Social Worker who provides counseling, resource identification and education. Patients are provided with treatment summaries and survivorship plans to follow at the end of treatment through sessions with the Oncologist or the Nurse Practitioner. The focus of Survivorship is maximizing quality of life for the person with cancer after they have completed active treatment through the rest of their life. EXPERT PHYSICIANS. QUALITY HOSPITALS. SUPERIOR CARE. 15

18 FOOD FOR LIFE The Cape Cod Healthcare Regional Cancer Network joined this year with Joanne Irwin, M.Ed. Food for Life Instructor/Consultant, Physicians Committee for Responsible Medicine to offer four sessions in a series called Food For Life. The Food for Life program is a direct service nutrition education program of Physicians Committee for Responsible Medicine (PCRM), founded in 1985 by Dr. Neal Barnard. Dr. Barnard is one of American s leading advocates for health, nutrition, and higher standards in medical research. PCRM s staff includes physicians, scientists, registered dietitians, and other health care professionals. The Food for Life nutrition and cooking class program was launched in 2001 to help cancer survivors take advantage of the healing power of foods. Certain diet patterns seem to have a major effect in helping cancer survivors to live longer, healthier lives. Numerous studies have shown that a diet built from plant foods offers the most cancerfighting protection of any diet plan. Reviews by the American Institute for Cancer Research showed that as much as 40% of cancer risk may be related to diet. Cancer Prevention/Survival Topics include: Week One: How Foods Fight Cancer Week Two: Fueling Up on Low-Fat, High-Fiber Foods Week Three: Discovering Dairy and Meal Alternatives Week Four: Cancer-Fighting Compounds and Immune Boosting Foods We are fortunate to have Irwin provide the Food For Life program through our Community Benefits Department for the Cape Cod Community. 16 Cape Cod Healthcare Regional Cancer Network 2014

19 For general information on services available, statistics or information, please contact: CAPE COD HOSPITAL Davenport-Mugar Cancer Center at Cape Cod Hospital: FALMOUTH HOSPITAL Clark Cancer Center at Falmouth Hospital:

20 Cape Cod Healthcare 88 Lewis Bay Road Hyannis, Massachusetts CapeCodHealth.org