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The Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine is an international leader in cancer treatment, research, prevention, education, and community outreach. It is the only cancer center in Missouri and within a 240-mile radius of St. Louis to hold the Comprehensive Cancer Center designation from the National Cancer Institute (NCI). Parent institutions Barnes-Jewish Hospital and Washington University School of Medicine also are nationally recognized, with U.S. News & World Report magazine consistently ranking the hospital in the top 10 and the medical school in the top five.

Siteman offers the expertise of more than 350 Washington University research scientists and physicians who provide care for more than 7,000 newly diagnosed cancer patients each year. A full range of advanced diagnostic and treatment services are available in a state-of-the-art outpatient facility for patients with all types of cancer. Patients have access to support services throughout their care; Siteman’s Barnard Health and Cancer Information Center served nearly 19,000 individuals in 2006 through its education and support programs.

Scientists and physicians affiliated with Siteman hold nearly $150 million in cancer research and related training grants. This includes federally funded translational initiatives in nanotechnology, chemoprevention, gene therapy, proteomics, imaging, genomics, and leukemia and lymphoma. More than 30 multiproject or collaborative cancer grants are held by Siteman investigators.

State-of-the-art research facilities include Washington University’s world-renowned Genome Sequencing Center and a Good Manufacturing Practice laboratory for the production of cellular and biological products, which is one of the largest facilities of its type at a U.S. academic medical center.

Patients have access to more than 350 clinical trials, including many collaborative efforts with other leading cancer centers, enhancing Siteman’s bench-to-bedside care approach. Washington University’s Mallinckrodt Institute of Radiology was a founding member of the Radiation Therapy Oncology Group, and Siteman participates in a variety of other cooperative clinical research groups.

As a Comprehensive Cancer Center, Siteman is committed to community outreach, education, and screening. Last year, the cancer center sponsored more than 250 events with nearly 15,000 participants. Siteman’s Program for the Elimination of Cancer Disparities strives to reduce barriers to cancer education, care, and research for underserved groups. In 2005, the program received a $1.25 million grant from the NCI in support of its work.

Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
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 A.G. Edwards 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

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, Missouri. 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—Includes a clinic for the evaluation of suspicious lung nodules
• 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 260, fairly evenly divided between autologous and allogeneic transplants. Approprixmately 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. The service recently received recertification through the Foundation of Cellular Therapy (FACT) program.

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 2005, the mobile mammography program served over 8,000 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 works in close collaboration with colleagues from the Saint Louis University School of Public Health, which 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 “wayfinding” navigation, 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, children of mothers and grandmothers with 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 also 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. The center is staffed with nurses who can provide additional information and support to patients and families, linking them to appropriate resources. It also provides wigs, breast prostheses, and bras for uninsured/underinsured women who have had mastectomies and offers arts as healing projects, including drawing classes.

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 and an outpatient palliative care clinic were 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

Clinical and Research Efforts

Adult Oncology Program - 2006

* Total of outpatient oncology visits of 92,267

Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
Genetic Counseling and Testing Service

The Hereditary Cancer Program at the Siteman Cancer Center offers clinical genetic assessment to people who have a family history of cancer to assess their cancer risks and identify appropriate family-based medical management. The program includes a medical geneticist and three genetic counselors. This team sees over 150 families a year, many of whom are referred by their own primary care physicians. At the Siteman Cancer Center, comprehensive genetics evaluations are initated to identify personalized risks for developing cancer with a hereditary tendancy. Based on the findings of individualized evaluations, potential need for genetic testing, surveillance, and medical care options are reviewed with patients and appropriate family members, as necessary. The Hereditary Cancer Program members are very actively engaged in research occurring at the Siteman Cancer Center to better understand the specific mutations in genes that control cell growth and the repair of damaged genes. Studies of genes that play a role in the more common cancers are also underway at the Siteman Cancer Center.

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Intake Process

Testing

Post-Test Counseling and Follow-Up

Research

Last updated: 2/20/2008