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ANNUAL REPORT with a special focus on COLON CANCER


Battle Creek

A Word from the COO Dear Friends, I am proud to introduce Bronson Battle Creek Cancer Care Center’s Annual Cancer Report for 2017. With a special focus on colon cancer, this report highlights our comprehensive approach to colon health. From testing and diagnostics, to treatment to survivorship planning, our exceptional team works together closely to provide our patients and community with the highest level of care. In this report, we’ve also included local and national cancer data so you can see how well our performance compares to others. Since 1995, Bronson Battle Creek has been recognized by the Commission on Cancer of the American College of Surgeons. With an exemplary staff, leading technology and research, we have the highest level of confidence in the programs and clinical outcomes we deliver. I hope you find our 2017 annual report informative. If you have any questions about The Cancer Care Center and our capabilities, please contact us at (269) 245-8056 (radiation oncology) or (269) 245-8660



CANCER CARE CENTER SPECIAL FOCUS ON COLON CANCER Colon Cancer Overview . . . . . . . . . . . . . . 3 Stages of Colorectal Cancers . . . . . . . 3 Treating Colon Cancer . . . . . . . . . . . . 3 Oncology and Hematology Update . . . . 5 Advances in Cancer Research . . . . . . 5 Radiation Therapy for Colorectal Cancers . . . . . . . . . . . . . . . 6 About the Cancer Care Center . . . . . . . . 6

(medical oncology). Supportive Care and Survivorship for Colon Cancer . . . . . . . . . . . . . . . . . 7 The Three Phases of Colon Cancer . 7 Coordinating Care with Your Primary Care Provider . . . . . . . . . . 8


Nationally Recognized Cancer Care . . . . 7

Jim McKernan Chief Operating Officer

Screning for Colorectal Cancer . . . . . . . . Screening Guidelines . . . . . . . . . . . . . Surgical Oncology Services: Cytoreductive Surgery & HIPEC . . Family History and Risk . . . . . . . . . . . Preventing Colon Cancer Risk through Diet and Exercise . . . . . Free Colonoscopy Program for the Uninsured . . . . . . . . . . . . . . . . . . . Get Your Colon Rollin’ . . . . . . . . . . . Our Commitment to Excellence . . . . . . . 2013–2016 Performance Measures

Bronson Battle Creek


9 10 10 10 10 10 10 11



Colon Cancer Overview

By Niyati Bhagwati, MD, Bronson Oncology & Hematology Specialists Combined, colorectal cancers (CRCs) are the third most common cancer affecting men and women in the United States. The majority of these — 70 percent — arise in the colon. The American Cancer Society estimates that by the end of the year, 95,520 new cases of colon cancer will have occurred in the United States in 2017. Death rates from CRCs overall have dropped progressively since the mid-1980s in the U.S. and in most Western countries. This improvement in outcome is due, at least in part, to detection and removal of potentially cancerous polyps, detection of CRCs at an earlier stage, and more effective treatments. Symptoms of colorectal cancer may include:

Stages of Colorectal Cancers Tumors are first classified using the TNM (tumor, node, metastasis) system developed by the American Joint Committee on Cancer (AJCC). This method assesses the size and extent of the main tumor (T), the number of nearby lymph nodes (N), and whether or not the tumor has metastasized (M). Then, an overall stage is assigned. These stages range from stage 0 (no cancer found), stage I-II (cancer is confined to colon or rectum), stage III (cancer has spread to regional lymph nodes), to stage IV (cancer has spread to organs beyond the colon or rectum).

• Abdominal pain (bloating, gas, cramps or a feeling of fullness) • Blood in the stool or very dark stools • Changes in the frequency of bowel movements • Change in consistency of the stool, such as loose or watery stools • Constipation • Tiredness or lack of energy • Weight loss Treating Colon Cancer Surgery Colon cancer is treated with the surgical resection or removal of the tumor. At its earliest stages, surgery alone is the most common course of treatment. As the disease advances, chemotherapy with or without the addition of radiation may also be required. Stages 0–1 All or part of the colon and nearby lymph nodes are surgically removed. The surgeon removes the part of the colon with the cancer and a small segment of normal colon on either side of the cancer. Usually, about one-fourth to one-third of the colon is removed, but this depends on the size and location of the cancer. The remaining sections of the colon are then reattached. If the entire colon is removed, it is called a total colectomy. A total colectomy, however, is not often needed to treat colon cancer. It is generally used in inflammatory bowel disease, or if there is disease in the part of the colon without the cancer, such as hundreds of polyps in someone with familial adenomatous polyposis. Chemotherapy: Stage II–III Colorectal Cancer Neoadjuvant chemoradiotherapy (chemotherapy in addition to surgery) given preoperatively or prior to surgery is a common approach for locally advanced rectal cancer. Combining chemotherapy and radiation has been shown to shrink the tumor, making it easier to cleanly remove all of the disease during surgery. For patients who have undergone a potentially curative resection of a colon cancer, adjuvant chemotherapy postoperatively is often recommended to reduce the likelihood of the disease recurring. For patients with stage III (node-positive) disease, research has shown a clear benefit in this approach. (continued on page 4)




Colon Cancer Overview (continued from page 3) Most treatments involve a combination of several chemotherapy drugs, which are given intravenously, in a specific order, on specific days. For patients with node-positive colon cancer, for example, a six-month course of Fluorouracil, leucovorin and oxaliplatincontaining chemotherapy is generally recommended for most patients, although the benefits of oxaliplatin are controversial in the elderly. Among patients with resected node-negative (stage II) disease, the benefits of chemotherapy are controversial. Treatment decisions must be individualized. Recommendations are made based on the symptoms of the disease as well as pathology from the tumor, an assessment of comorbidities, and anticipated life expectancy, and — given the relatively good prognosis of stage II disease — the potential risks associated with treatment. Stage IV Colorectal Cancer: Resectable Metastatic Colorectal Cancer

Improvement in outcomes is due, at least in part, to detection and removal of potentially cancerous polyps, detection of CRCs at an earlier stage, and more effective treatments.

Sometimes surgery is an option for a person whose colorectal cancer has spread in a limited way outside of the intestine to an area such as the liver. Up to 30 percent of people may be cured if metastases in the liver can be completely removed. Patients should have a consultation with an experienced surgical oncologist before deciding upon a treatment plan. Chemotherapy may be recommended before surgery because of the size or location of the tumors. If surgical removal of the liver metastases is successful, additional chemotherapy is often recommended after surgery. At some institutions, the chemotherapy is given directly into the liver (an approach called hepatic intraarterial chemotherapy) with or without additional chemotherapy given into the veins (intravenous chemotherapy). Surgical treatment may also be considered for a patient with a limited amount of metastatic disease in the lung. Chemotherapy for Unresectable Metastatic Colorectal Cancer As noted above, surgery is the only way to cure metastatic colorectal cancer. In most cases, however, surgery is not possible, and chemotherapy is recommended to reduce symptoms and prolong survival. This treatment is palliative and not intended to cure metastatic colorectal cancer. Conventional Chemotherapy Conventional chemotherapy drugs work by interfering with the ability of rapidly growing cancer cells to divide or reproduce. The conventional chemotherapy drugs used to treat metastatic colorectal cancer include Fluorouracil (FU), which is usually given into the vein with a second drug called leucovorin to enhance its activity, and orally active FU-like drugs such as Capecitabine. Drugs such as Oxaliplatin and Irinotecan are used in combination with 5-FU, both of which are given intravenously. Targeted Therapy  Other drugs inhibit specific proteins that the colon cancer cells need to survive. Currently available targeted chemotherapy agents include Bevacizumab, which binds to a protein called vascular endothelial growth factor (VEGF), which shuts off the growing cancer’s blood supply. Cetuximab and Panitumumab bind the epidermal growth factor receptor (EGFR), found in select patients with colorectal cancers. Regorafenib is a pill that blocks several VEGF receptors as well as proteins referred to as kinases. l




Oncology and Hematology Update By Timothy Cox, MD, FACP, Bronson Oncology & Hematology Specialists The past year has been an exciting one of transition for the Oncology & Hematology Specialists at the Cancer Care Center. Building on the legacy of quality and care that’s always been our hallmark, four new providers bring fresh energy and perspectives to our work. Over the past year, we’ve increased our involvement with the Cancer Research Consortium of West Michigan. Funded by the National Cancer Institute, our membership in the consortium gives our patients access to well over 100 national clinical trials for a variety of cancers, patient support and cancer prevention. In addition to participation in national clinical trials, local trials are now available through our association with the Western Michigan University Homer Stryker M.D. School of Medicine. We’ve also become more active with the Michigan Oncology Quality Consortium (MOQC). This is a group of more than 40 oncology practices throughout Michigan that collect and share data to drive quality and improve patient outcomes. We continue to focus our work on the needs of our local community through our participation with the Calhoun County Cancer Control Coalition (the 5C’s), an organization we’ve been committed to since it was first established in 2005. This year, our work with the 5C’s includes leadership in the Black Butterfly Project, a program to increase access to improved breast health for African American women. Advances in Cancer Research Among the most exciting advances in the treatment of cancer is the increasingly precise way in which we can target cancer treatments to the individual patient. For many years, research focused primarily on how cancer cells develop and reproduce. How breast cancers spread compared to the growth of lung or colon cancers, for example. While important, these advances were limited because a particular type of cancer may act differently in different people.

We are now pairing our understanding of how cancers reproduce with research into how an individual’s unique cells may influence or affect that cancer. This is a revolutionary leap forward in fighting cancer that is largely the result of our ability to sequence genomes quickly and cost effectively. Most people today are familiar with the idea of genome sequencing. It’s what makes it possible to trace ancestry by analyzing an individual’s saliva. Similarly, cancer genome sequencing allows researchers to identify what specific mutations take place in a person’s normal cells that lead to the development of cancerous cells. With that knowledge, we can develop very precise and individualized strategies for cancer treatment. An individualized cancer treatment plan may include the use of immunotherapies. Immunotherapies stimulate a patient’s own immune system to fight the cancer. Immunotherapy may also include the use of chemotherapy drugs to boost the patient’s immune system. Precision medicines are another tool used in personalized cancer care. Precision medicines use information about a patient’s genes, proteins, and environment to treat his or her cancer. This comprehensive profile is compared to all the available drugs — across multiple pharmaceutical companies — to select the best match. Advances in technology make the drug profiles readily available and drug makers are working with each other, with the FDA, the National Cancer Institute, and national research groups in an unprecedented effort to combat cancer cooperatively. Our persistent progress makes cancer an increasingly chronic disease with life expectancies that continue to rise. In Calhoun County alone, the American Cancer Society estimates there are more than 13,300 cancer survivors. While deaths from all cancers still occur, advances in diagnostics and treatments — including immunotherapies, precision medicines, traditional chemotherapy and radiation treatments — and ever more advanced technology enable us to prescribe increasingly individualized care plans. l


Our persistent progress makes cancer an increasingly chronic disease with life expectancies that continue to rise.



Radiation Therapy for Colorectal Cancers By Randy Mudge, MD, Chief of Staff and Clinical Director, Radiation Oncology

Radiation therapy is used to treat colon cancer when the cancerous tumors have spread beyond the wall of the colon and are adherent to or invading another organ or the abdominal wall. Although it is rare to see colon cancer this extensive, when it occurs, radiation therapy can be effective in controlling the cancer from spreading further. For rectal cancer, radiation treatment is indicated when the cancer has invaded into the wall of the bowel or involved the lymph nodes. Radiation may also be recommended in combination with chemotherapy following surgery. When combined with chemotherapy, radiation has been shown to have a survival advantage and to decrease the likelihood of a recurrence of the cancer.

The Commission on Cancer has accredited Bronson Battle Creek since 1995. Accreditation ensures that patients are treated according to nationallyaccepted quality guidelines.

For some rectal cancers, radiation may be combined with chemotherapy prior to surgery. This treatment regimen is especially common for patients with large, high-risk cancers. This approach offers several advantages. Combining the treatments can help shrink the tumor before surgery. It also introduces the chemotherapy drug into the body sooner, which means it can begin working sooner. Waiting until after surgery delays the introduction of chemotherapy by several weeks during the surgical recovery process. Finally, in cases where the patient is at borderline risk for a colostomy, combining radiation with chemotherapy may enable surgeons to save the bowel and eliminate the need to reroute the intestine. Stereotatic Body Radiation Therapy (SBRT), which has been used successfully in lung cancers, is now being used for select patients with colon or rectal cancer. SBRT delivers a very high dose of radiation in a precise and highly targeted manner. Properly selected patients treated with SBRT have excellent local control rates equal to patients who have surgery. For colon or rectal cancer, it is indicated in patients with a small number of metastatic deposits in their liver. Although these deposits are typically treated surgically, for patients who are not candidates for surgery it may be treated with SBRT. In cases of both colon and rectal cancers, radiation also plays an important palliative role. For example, if the cancer has spread to the bone, radiation is more effective in pain relief and more cost effective than pain medications alone. If the cancer has spread to other areas, radiation can be used in select cases depending upon the location and symptoms. Radiation therapy also reduces the risk of addition to opioids, which are also used to control pain. l

Screening for Cancer Getting screened for cancer is something that is often done because it is recommended by your physician and by the American Cancer Society. Doctors take family history and risk factors into consideration when making individual recommendations, but the American Cancer Society has a standard set of guidelines for everyone. For more information on cancer screening guidelines, visit the American Cancer Society’s website at




Supportive Care and Survivorship for Colon Cancer By Zeeshan Tariq, MD, Bronson Oncology & Hematology Specialists

At the Cancer Care Center, a team of highly trained oncology professionals supports each patient. While we are working to eradicate the cancer, we also recognize that each patient is a person who may be overwhelmed by the complexity of his or her diagnosis and the long journey ahead. For this reason, a nurse navigator helps each patient coordinate care, make appointments and facilitate communication between the patient and the many clinical and support services required. The navigator’s job is to help the patient as they begin the process of living with their disease. Patients with advanced illnesses, regardless of the type of cancer, receive additional support from a nurse practitioner who is specially-trained in complex disease management. When cancer is first diagnosed, the patient becomes a cancer survivor. It is a term they will carry throughout their lifetime. For colon cancer, as with any cancer, the survival journey has three distinct phases: The Three Phases of Colon Cancer

Nationally Recognized Cancer Care

1 Diagnosis to the end of initial treatment Once colon cancer has been detected, our medical oncology team will work with each patient to determine the most appropriate course of treatment. Most often this will include surgery. It may also include adjunctive chemotherapy before or after surgery and possibly radiation therapy. 2 Transition from treatment to extended survival Once the initial treatment phase is complete, treating colon cancer becomes a matter of caring for the cancer survivor. This includes continuous monitoring through a series of screening tools to ensure that the cancer does not return and that no new cancers develop. Once an individual has developed any type of cancer, they are at a higher risk for incurring other cancers. But with close monitoring cancer can be detected early, when it is most treatable. Monitoring will include bloodwork, CT scans of the chest, abdomen and pelvis, and colonoscopies. Intensive at first, the frequency of each test decreases over a five-year period if no signs of cancer are seen. 3 Extended survival At five years after completing initial treatment, patients enter long-term survival. Some monitoring will be required throughout the patient’s lifetime, but much less frequently. CT scans are not typically taken during this phase, but colonoscopies will remain necessary at regular intervals.

(continued on page 8)

A nurse navigator helps each patient coordinate care, make appointments and facilitate communication between the patient and the many clinical and support services required.


Bronson Battle Creek Cancer Care Center is accredited by The Joint Commission, having earned its Gold Seal of Approval. The Commission on Cancer Comprehensive Community Program ranks the Center among the top cancer centers in the nation. The Center is one of only 25 hospitals in the country to receive an outstanding achievement award from the American College of Surgeons Commission on Cancer three times in a row.



Supportive Care and Survivorship for Colon Cancer (continued from page 7) When we see patients for follow-up care, we are of course looking to make sure that there is no recurrence of cancer. We are also looking for complications, however, which may arise at any point throughout treatment and survival. This includes side effects of the medications, complications from surgery, or social and emotional affects common among cancer patients, such as depression or anxiety. Coordinating Care with your Primary Care Provider

Many insurance companies are now classifying colon screening as preventative therapy. Be sure to check with your insurance carrier to see if colon cancer screening is a benefit they offer.

When a patient’s initial treatment for cancer ends, their follow-up screening may be done through their primary care provider, or within their local hospital if they live outside the Battle Creek area. The Cancer Care Center sends a report to the patient’s primary care provider, Our nurse navigator will coordinate initial support services, answer questions and facilitate communication among providers. With each annual physical, it’s important to not only undergo any required tests, but to discuss how you’re feeling emotionally, whether you have a supportive social circle, and to consider how you are coping with your cancer. Getting plenty of exercise and maintaining a healthy diet and positive attitude will always be important. Ostomy Support The Calhoun County Cancer Care Control Coalition (5Cs) offers ostomy support and education. Visit them online at l

Recognizing Stress One of the tools recently introduced at The Cancer Care Center is a screening assessment for distress. Just as we ask patients, “On a scale of 1-10, what is your pain level today?” we now also ask, “What is your level of distress or anxiety?” This tells our care team that the patient may need more help managing the stress of their treatment. This is especially helpful for our nurse navigator or advanced illness management teams who will bring the most appropriate resource to each patient’s care. This may include financial aid counseling, emotional counseling, pain management, family education or self-help therapies.

Pet Therapy Fall of 2017, the Bronson Battle Creek Cancer Care Center launched their Pet Therapy program for patients. Studies have shown that pet therapy can improve overall well-being for cancer patients, while also lowering stress and anxiety levels. A cancer diagnosis can be emotionally overwhelming. Our goal is to make the journey through cancer care as positive as possible by utilizing programs such as this to enhance the patient experience.




Screening for Colorectal Cancer

By Nidhi Mishra, MD, Cancer Liaison Physician, Bronson Oncology & Hematology Specialists Colorectal Cancer (CRC) is a preventable disease, and is almost always curable when detected early. Both prevention and early detection can be achieved by screening. Before cancer develops, a tumor usually begins as a non-cancerous polyp on the inner lining of the colon or rectum. The goal of screening is to detect and remove these potentially precancerous polyps. CRC Screening has a Grade A rating from the U.S. Preventive Services Task Force (USPSTF). They recommend that all individuals over the age of 50 be screened for CRC. The USPSTF recommends three different types of screening tests: fecal occult blood testing (FOBT), flexible sigmoidoscopy or colonoscopy. There are two types of FOBTs (a chemical guaiac test and a Fecal Immunochemical Test — FIT). Each of these is performed annually. Instead of an annual stool test, a flexible sigmoidoscopy may be performed every five years to look for

cancerous growth in the rectum and lower third of the colon. The gold standard, however, is a colonoscopy. For those at average risk of developing colon cancer, it is recommended every 10 years to check the entire colon for cancerous growth. For individuals at increased risk of CRC, USPSTF recommends a more aggressive screening protocol. This may include starting the screening regimen earlier than the age of 50, having more frequent screenings, or both. High-risk individuals have one of the following: • A personal history of adenomatous polyps or a previous colonoscopy. • A personal history of CRC. • A family history of a parent, sibling, or child having CRC or adenomatous polyps. • A diagnosis of familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (HNPCC). • A history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease).

Screening Guidelines Screening Test

USPSTF Recommendation

Fecal occult blood test (FOBT)* or fecal immunochemical test (FIT)*

High sensitivity FOBT or FIT annually for adults aged 50–75 years.


Sigmoidoscopy every five years combined with FOBT every three years for adults aged 50–75 years.


Colonoscopy every 10 years for adults aged 50–75 years. USPSTF recommend Screening decisions for people aged > 75 years be made by the medical care provider and the patient on the basis of individual health status.

*Positive results require follow up colonoscopy.

(continued on page 10)


For those at average risk of developing colon cancer, it is recommended every 10 years to check the entire colon for cancerous growth.



Screening for Colorectal Cancer (continued from page 9) Family History and Risk If you have a family history of colon or rectal cancer, your doctor may recommend a colonoscopy younger than age 50. The two most common inherited syndromes linked with colorectal cancers are familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (HNPCC), sometimes called Lynch Syndrome. Less common syndromes that may increase your risk of developing colorectal cancer are Turcot Syndrome and Peutz-Jeghers Syndrome. Preventing Colon Cancer Risk through Diet and Exercise

To reduce the likelihood of developing colon or rectal cancer, The American Cancer Society recommends a healthy diet that is low fat. Studies also show that an active lifestyle can lower risk.

To reduce the likelihood of developing colon or rectal cancer, The American Cancer Society recommends a healthy diet that is low fat. Many studies have linked an increased risk of colorectal cancer to being overweight or obese. Having more belly fat is a specific risk indicator. Diets high in vegetables, fruits, and whole grains, and low in red and processed meats are linked to lower risk. Studies also show that an active lifestyle can lower risk. When it comes to exercise, the more regular and vigorous the activity, the better.

Free Colonoscopy Program for the Uninsured Most health insurance plans cover the cost of colonoscopies. For qualifying individuals without health insurance, The 5C’s, Bronson Battle Creek Hospital, Battle Creek Endoscopy & Surgery Center and Oaklawn Hospital have partnered to provide free colonoscopies for nearly four dozen patients each year who meet underinsured criteria and who are at risk for developing colon cancer. The program was the first of its kind in Michigan. For more information, contact the Cancer Care Center at (269) 245-8660. l

Get Your Colon Rollin’ Each year, the Calhoun County Cancer Control Coalition (5Cs) has held an annual Colon Cancer Awareness 5K Run/Walk. The event is intended to raise awareness of colon cancer and to encourage a healthy, active lifestyle in the prevention of colon and other cancers. The event is held each June. For more information visit

Surgical Oncology Services: Cytoreductive Surgery and HIPEC For colorectal cancer patients with peritoneal metastases that have not spread to organs such as the liver or lungs, or to lymph nodes outside the abdominal cavity, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) may be particularly helpful. Peritoneal metastases do not respond to systemic chemotherapy in the same fashion as liver and lung metastases. Cytoreductive surgery is surgery that attempts to remove as many cancerous cells as possible. HIPEC delivers chemotherapy directly to cancer cells in the abdomen. This allows for higher doses of chemotherapy treatment. Heating the solution may also improve the absorption of chemotherapy drugs by tumors and destroy microscopic cancer cells that remain in the abdomen after surgery. CRS and HIPEC have been proven to improve survival in many of the patients with this condition. As a part of the Bronson Healthcare system, the Cancer Care Center works closely with top surgical oncologists throughout southwest Michigan to provide a full range of surgical solutions to treat colon and rectal cancers. Patients have access to state-of-the-art care and expertise close to home. Our collaborative approach allows patients to benefit from having multiple cancer specialists working together to cure their colon cancer. l




Cancer Statistics Comparison Comparing national cancer statistics to the types of cancers, stages of cancer diagnoses and treatments offered at The Cancer Care Center is one way we work to ensure that we are providing state of the art care. And it helps us understand how our local patient population may differ from national cancer patients. This year, noteworthy findings include:

Bronson Battle Creek National Average

Ethnicity of Colon Cancer Diagnosed 2010–2014

• Like many cancers, colon cancer is more common in older patients.

100 90 80 70 60 50 40 30 20 10 0

• Colon cancer is known to be more common among men, and the national statistics reflect that. Locally, however, it affects slightly more women than men.

Percent of Cases

• Looking at the stage of diagnosis, we see that nationally — and especially locally — we must work to increase early screening and detection.

• Based on the distance traveled — and with our accreditation by the CoC — the Cancer Care Center provides excellent care close to home for many of our patients.



Age of Colon Cancer Diagnosed 2010–2014


Percent of Cases

Percent of Cases

70 60 50 40 30 20 10 0

0-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90+

<5 Miles

Gender of Colon Cancer Diagnosed 2010–2014

5-9 Miles 10-24 Miles 25-49 Miles 50-99 Miles >100 Miles


Stage of Cancer at Diagnosis 2010–2014

70 60 50 40 30 20 10 0

40 35 30 25 20 15 10 5 0

Percent of Cases

Percent of Cases


Distance Traveled 2010–2014

30 25 20 15 10 5 0











About the Cancer Care Center Bronson Battle Creek Cancer Care Center provides individualized patient treatment plans to support the body, mind, and spirit of its patients. Conveniently located next to Bronson Battle Creek Hospital, the Center specializes in a broad range of cancer services. They include diagnostics, genetics assessment, hematology, medical oncology and chemotherapy, pathology, radiation oncology and technology, and surgical oncology. Conferences for breast, thoracic and all other tumor sites regularly bring expert physicians together to review and discuss treatment options for individual patients. The Center is a member of the Cancer Research Consortium of West Michigan â&#x20AC;&#x201D; a combined effort of healthcare organizations in Michigan providing patients access to national clinical studies while remaining in their communities. For more information, visit

Battle Creek

Bronson Battle Creek Cancer Care 2017 Annual Report  
Bronson Battle Creek Cancer Care 2017 Annual Report  

with a special focus on Colon Cancer