Cary East Raleigh Garner Raleigh Main Raleigh Blue Ridge Wakefield

UNC REX CANCER CARE

ANNUAL REPORT 2018

A COMPREHENSIVE COMMUNITY CANCER PROGRAM Accredited by the American College of Surgeons Commission on Cancer

National Accreditation Program for Breast Centers

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On the cover: UNC REX Cancer Care of East Raleigh

117 Sunnybrook Road, Raleigh, NC 27610

UNC REX Cancer Care locations

Cary ~ East Raleigh ~ Garner ~ Raleigh Main ~ Raleigh Blue Ridge ~Wakefield

For more information or to schedule an appointment with UNC REX Cancer Care

Call 919-784-3105

www.REXhealth.com

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Mission

The mission of UNC REX Cancer Care is to provide our patients with exceptional cancer care and to ensure

timely and convenient access to the most effective strategies that prevent, treat, and ultimately cure cancer

in the future. UNC REX Cancer Care provides expert, compassionate care to patients with cancer through

close collaboration among providers across all disciplines of oncology.

Core Values

Impact

We strive to provide timely access to care in a caring and compassionate setting close to patients’ homes

and to relieve the burden of disease now and for the future through our research, clinical care, education,

outreach and advocacy.

Excellence

We pursue excellence relentlessly and with integrity in all that we do, adhering always to the highest

standards of conduct.

Compassion and Respect

We strive to exceed expectations for compassion and respect for those in our care and for one another.

UNC REX Cancer Care

Mission and Core Values

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UNC REX Cancer Care Annual Report 2018

Table of Contents Page

Mission & Core Values 3

A Letter from Our Cancer Committee Chair 5

Introduction 6

Accreditations and Eligibility Requirements 7

Publications and Presentations 8

Cancer Registry Site Distribution 9

Quality and Accountability Measures 10

Cancer Program Quality Studies 11

Cancer Research and Clinical Trials 12

Community Cancer Care 13

Cancer Care Services and Locations 14

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Dear Friends,

As my time as Chair of the UNC Rex Cancer Committee draws to a close, I would like to reflect on our

accomplishments together over the last 3 years. We received re-accreditation by the American College of

Surgeons Commission on Cancer in April 2017. This accomplishment is due to the wonderful collaborative

and ongoing efforts of every member of the Cancer Committee in addition to the steadfast works of Kathy

Foote, our Tumor Registry Manager, and Cynthia Jones, our Quality Leader.

In these last three years, we have seen significant growth in a number of key areas. We have opened our newest

suburban ambulatory cancer center, the Rex Cancer Center of East Raleigh. We have expanded our excellent

patient navigation program and added tumor boards in gynecologic oncology, urology, and

leukemia/lymphoma, to our already robust programs in breast, gastrointestinal, and thoracic oncology. Our

surgeons, radiologists, medical oncologists, and radiation oncologists have completed a number of quality

projects that have helped to improve and optimize the care we provide to our patients. In addition, we have

seen multiple strategic improvements in Survivorship Care Plans and successful delivery in key populations.

Our low dose CT lung cancer screening progressed and initiated smoking cessation programs as well as plans

are underway for a pulmonary nodule program.

In 2019, we are very excited to break ground on our new cancer center in Raleigh, in which we will be able to

more seamlessly house state of the art cancer treatment and support services under one roof. We will continue

to provide and expand specialty cancer services in Wake County, so patients may receive outstanding care close

to home. We aim to expand our clinical research program to enroll even more patients on local and national

trials.

It has been an honor to serve as Chair of the Cancer Committee. Many thanks to all of our physicians and staff

and co-workers at UNC Rex Cancer Center who serve our patients, their families, and caregivers with the best

in evidence based care and compassion.

A Letter from Our Chair - UNC REXCancer Care Committee

Courtney Bui, MD, MSPH

UNC REX Radiation Oncology

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Introduction The UNC REX Cancer Care Committee is the designated multidisciplinary body for program leadership,

administrative oversight, development, and review of oncology services at UNC REX Cancer Care. The Cancer Care

Committee is a committee of the UNC REX Hospital Medical Staff responsible for the overall direction of the

oncology program including coordination with Hospital and UNC Health System leadership. Its composition, as

required by the Commission on Cancer, includes Board-certified physicians from Surgery, Medical Oncology,

Radiation Oncology, Diagnostic Radiology, and Pathology, along with the Cancer Liaison Physician, Clinical

Research Manager, Palliative Care Specialist, and representatives from Hospital Administration, Nursing, Pharmacy,

Psychosocial services, Cancer Registry, and Quality.

Annually, as required by the Commission on Cancer, the UNC REX Cancer Care Committee develops an annual

report with dedicated focus on program quality and outcomes. These findings are published each year through the

UNC REX Cancer Annual Report and available to public.

Cancer Care Committee Membership 2018

Courtney Bui, MD Committee Chair

Richard Gillespie, MD ACoS Cancer Liaison Physician/ Thoracic Surgery

Susan Moore, MD Medical Director, Rex Hematology Oncology Associates

David B. Eddleman, MD Surgeon / Breast Care Committee Chair

Tom Grates, MBA Executive Director, UNC REX Cancer Care

Chad Lefteris, MHA VP Operations UNC Rex Health

Hiren Mehta, MD / Barbara Dull, MD Chair Cancer Conference Committee

Charles Eisenbeis, MD / Brenden McNulty, MD Medical Oncology

Nathan Sheets, MD Radiation Oncology

Keith Volmar, MD / Keith Nance, MD Pathology

Duncan Chapman, MD / David Schulz, MD Diagnostic Radiology

Kathleen Foote, MBA, CTR Cancer Registry Manager

Nancy Burns, RN, OCN / Lolita Forrest, PhD Cancer Research /Clinical Trials

Cynthia Jones, BS, CPHQ /Heather Sasser, RN Quality Coordinator /Quality & Org Excellence Leaders

Kimberly Fradel, MSW,LCSW /Paige Moise, MSW Social Work /Psychosocial Services Coordinator

Rachel Smith, M. Div, THM/ Ann Yeager, MD Palliative Care (IP)

Kim Hurley, RN, OCN /Sharon Kauffman, MSN Oncology Nurse Manager (OP) / Clinical Leadership

Catherine Fine, MS, CGC / Ofri Leitner, MS, CGC Genetic Counseling

Emmeline Madsen, MPH Community Outreach Coordinator / Director

Additional Supporting General Membership 2018

Susan Mondo, RN, MSN ~ Navigation Douglas Hammer, MD ~ Family Practice

Nihan Cannon, MD ~ Hospitalist Rebecca Jones, PharmD ~ IP Pharmacy

Jon Gerber, PharmD ~ OP Pharmacy Suzanne Smith, RD, CSO, LDN~ Nutrition

Jennifer Headen, MHA ~ RHOA Administrator Kelsey Williams, RN, Manager (IP)

Margret Hartfield, OTR ~Rehab Robbie Tilley ~American Cancer Society

Gordon McGirt, MBA~Garner Manager (OP) Katie Hardison, BS ~Staff /Committee Assistant

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UNC REX Cancer Care Accreditations

UNC REX Cancer Care is voluntarily accredited by the American College of Surgeons Commission (ACoS) per

the Commission on Cancer (CoC) Standards as a Comprehensive Community Cancer Program (CCCP). The pro-

gram assesses more than 3,000 newly diagnosed cancer cases each year, provides a full range of diagnostic and

comprehensive treatment services as noted below, either on-site or by referral, as well as participates in cancer-

related clinical research and cancer-related clinical trials, per CoC Standards.

UNC REX Cancer Care is also voluntarily accredited by the National Accreditation Program for Breast Centers

(NAPBC). The NAPBC holds organizations to the highest standards of care for patients with diseases of the breast.

UNC REX is accredited by the Joint Commission and ACR Breast Imaging Center of Excellence.

UNC REX Cancer Care meets and /or exceeds the Commission on Cancer 12 Eligibility Requirements:

Eligibility Requirements Specifications

Cancer Committee Responsibilities Annual monitoring, assessing, and identifying changes that are needed in

each of the eligibility requirements.

Facility Accreditation The facility is accredited by a recognized federal, state, or local authority.

Cancer Committee Authority Bylaws or policy and procedure define the cancer committee’s authority and

responsibility for the program.

Cancer Conference Policy Program policy addresses the frequency, format, multidisciplinary attend-

ance, attendance rate, prospective case presentations and total case presenta-

tions, discussion of stage and treatment planning, clinical trial options, and

methods to address opportunities.

Oncology Nurse Leadership An oncology nurse provides leadership within the program.

Cancer Registry Policy & Procedure Policy and procedure addresses the use of Commission on Cancer data & all

other cancer registry activities.

Diagnostic Imaging Services are provided. *

Radiation Oncology Services Radiation treatment service locations are currently accredited by a recognized

authority or, if not accredited, follow standard quality assurance practices. *

Systemic Services Policies or procedures are in place to guide the safe administration of sys-

temic therapy.*

Clinical Trial Information A policy or procedure is used to inform patients about clinical trials.

Psychosocial Services A policy or procedure is in place to ensure patient access to psychosocial ser-

vices.*

Rehabilitation Services Rehabilitative services are provided. *

Nutrition Services Nutrition services are provided.*

Source: CoC, 2016 * Services are available either on-site, at locations that are facility owned, or by referral.

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UNC REX Cancer Excellence in Publications and Presentations

UNC REX Cancer Care Team advancing oncology care through professional publications, posters and presentations

PUBLICATIONS and PRESENTATIONS

Beta-blocker therapy for the prevention of doxorubicin-induced cardiotoxicity in patients with can-

cer: a retrospective cohort study. Olivia Witt, PharmD; David Blanchard, RPh; Rebecca Jones,

PharmD, BCPS, CPP; Oksana Kamneva, PharmD, BCPS-AQ Cardiology; Stephanie Baumhover,

PharmD, BCPS.

Breast Case of the Day: 104th Scientific Assembly and Annual Meeting. Radiologic Society of North

America meeting, Chicago IL. Holley, Susan, MD.PhD., (Co-Author) 2018 Nov 25.

Evaluating the relationship between smoking status and response rate to pembrolizumab in patients

with metastatic non-squamous non-small cell lung cancer. Rebecca Nickell, PharmD; Rebecca

Jones, PharmD, BCPS, CPP; Stephanie Baumhover, PharmD, BCPS; Brandon Ramsey, PharmD,

MSCR, MBA; Juliana Lipetzky, PharmD.

Evaluation of bleeding incidence rates of direct oral anticoagulants versus enoxaparin in the treat-

ment of venous thromboembolism in cancer patients with chemotherapy-induced thrombo-

cytopenia. Justin Wilson, PharmD; Rebecca Jones, PharmD, BCPS, CPP; Walter Laundon,

PharmD, MS, BCPS; Jared Peak, PharmD, BCACP, CPP; David Blanchard, RPh.

Interpathologist diagnostic agreement for non-small cell lung carcinomas using current and recent

classifications. Funkhouser WK, et al (including Volmar KE). Arch Pathol Lab Med. 2018 Apr 30.

Pharmacological Management Elements in Ovarian Cancer. Kappa Epsilon Pharmacy Lecture, Camp-

bell University, Buies Creek, NC. 2018, Feb1. Jonathan Gerber, PharmD.

Surgical pathology diagnostic error prevention. United States and Canadian Academy of Pathology An-

nual Meeting. CME course. Nakhleh RE and Volmar KE. Vancouver BC, March 2018.

Comprehensive Breast Cancer Care: A Guided Tour for Providers. NC Heart & Vascular Hospital –

Center for Innovation and Learning, Raleigh, NC. Wake AHEC. 2018 Oct 27.

Breast cancer from a patient’s perspective. Anna Crollman, Survivor Advocate

Clinical evidence in breast cancer screening recommendations. Tina Sprouse, MD

Complexities of axillary management in current breast care. Rachel Jendro, DO

Hereditary breast cancer. Ofri Leitner, MS, LCGC

Lymphedema therapy and care for breast cancer patients. Katie Marakas, DPT

Post mastectomy reconstruction: What to know & what to look for. Glenn Lyle, MD

Radiation therapy for breast cancer. Bryon Huff, MD

Role of patient navigation in care co-ordination and support. Kristin Knott, RN, BSN

Role of physical therapy in Breast Cancer Rehabilitation. Connie Nehls, MS, PT, CLT

Surgical options and consideration in breast cancer care. Barbara Dull, MD

The role of staging in breast cancer care. Beau Eddleman, MD

Updates in breast cancer endocrine therapy and associated side effects. Lola Olajide, MD

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PRIMARY SITE TOTAL CLASS SEX AJCC STAGE

A N/A M F 0 I II III IV Unk N/A

ALL SITES 3753 3156 597 1488 2265 293 1015 675 463 552 367 388

BREAST 1084 971 113 9 1075 145 477 261 75 38 88 0

DIGESTIVE 593 511 82 313 280 20 101 101 144 156 66 5

Esophagus 32 28 4 24 8 1 2 3 5 16 5 0

Stomach 55 49 6 39 16 0 14 8 6 19 7 1

Colon 185 170 15 87 98 0 45 33 53 37 17 0

Rectum 93 83 10 55 38 0 13 10 37 15 18 0

Anal 40 22 18 13 27 19 3 10 5 0 3 0

Liver 30 20 10 18 12 0 3 3 3 15 4 2

Pancreas 90 76 14 45 45 0 10 22 16 41 1 0

Other 68 63 5 32 36 0 11 12 19 13 11 2

RESPIRATORY 395 366 29 183 212 2 104 29 72 168 19 1

Larynx 24 21 3 18 6 0 7 5 3 8 1 0

Lung: SC 72 68 4 27 45 0 12 2 18 38 2 0

Lung: NSC 291 269 22 133 158 2 83 22 51 119 14 0

Nasal/Sinus 3 3 0 2 1 0 0 0 0 1 2 0

BLOOD & BM 278 204 74 144 134 0 0 0 4 2 5 267

Leukemia 120 81 39 67 53 0 0 0 4 2 3 111

Multiple Myeloma 55 40 15 26 29 0 0 0 0 0 2 53

Other 103 83 20 51 52 0 0 0 0 0 0 103

MALE 403 256 147 403 0 2 52 197 42 47 62 1

Prostate 387 243 144 387 0 0 47 197 41 47 55 0

Testis 13 12 1 13 0 0 5 0 1 0 7 0

URINARY 216 176 40 152 64 74 53 17 10 20 42 0

Bladder 135 111 24 106 29 72 27 13 4 9 10 0

Kidney/Renal 81 65 16 46 35 2 26 4 6 11 32 0

GYN 183 134 49 0 183 8 66 8 42 24 33 2

Cervix Uteri 18 9 9 0 18 2 5 1 4 4 2 0

Corpus Uteri 93 75 18 0 93 0 47 4 18 7 17 0

Ovary 40 29 11 0 40 0 10 2 12 9 7 0

Vulva 14 7 7 0 14 6 2 0 0 1 5 0

SKIN 153 142 11 97 56 42 64 18 8 7 9 5

Melanoma 144 134 10 92 52 41 62 16 8 6 8 3

LYMPHATIC 139 127 12 63 76 0 20 27 32 48 10 2

Hodgkin's 21 21 0 9 12 0 1 10 6 4 0 0

Non-Hodgkin's 118 106 12 54 64 0 19 17 26 44 10 2

ENDOCRINE 131 120 11 30 101 0 72 3 18 9 18 11

Thyroid 120 114 6 27 93 0 72 3 18 9 18 0

ORAL 56 48 8 41 15 0 3 8 10 30 4 1

Tongue 13 11 2 9 4 0 0 1 2 10 0 0

Other 41 35 6 30 11 0 3 7 8 18 4 1

BRAIN & CNS 63 48 15 26 37 60

Brain (Malignant) 18 15 3 11 7 Brain & CNS Tumors - World Health Organization (WHO) Grading System

17

Other 43 31 12 15 28 41

CONT TISSUE 16 14 2 6 10 0 3 5 4 0 4 0

Very low volume “other” sub-groups have been omitted from this table. Diagnosis group totals are complete

UNC REX Cancer Registry Site Distribution Detail CY 2017

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Rapid Quality Reporting System UNC REX is proud to utilzie the Rapid Quality Reporting System (RQRS) as an early adaptor prior to the

2017 CoC requirement. RQRS helps programs deliver evidence-based cancer care and facilitate quality

improvement with concurrent patient data. Through RQRS’ web-based tool, programs receive notifications

of treatment expectations and timeliness of care.

In addition, RQRS real time data alerts notify the service of year-to-date concordance rates for each

measure, case details, and comparison to state, other hospital groups, and hospitals at the national level.

Through active utilization of RQRS, UNC REX is in excellent standing for the current measures.

Importantly to note is the significance of the designated Accountability Measures as endorsed by the Na-

tional Quality Forum (NQF). Our performance against Expected Performance Rates (EPR) are:

Measure UNC REX ACoS CoC Expected Performance Rate

BCSRT (Breast) 92.7% EPR 90%

HT (Breast): 98.1% EPR 90%

MAC (Breast): 100% None at this time

MASTRT (Breast) 100% EPR 90%

ACT (Colon) 100% None at this time

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UNC REX Cancer Care Quality Studies in 2018

UNC REX was selectd to participate in a collaborative study of quality with the ACCC

and supporting organizations on three key care treatment process measures for HER2+ Breast Cancer

with focus on treatment in community cancer centers. The measures were selected to assess delivery

of most current evidence based practices and effective coordinaton of care in the community program

setting. A total of 87 patients met inclusion criteria for study.

For reference: Study based on NQF Measure #1858, MIPS Quality Measure #450, NCCN Guidelines.

Study sponsor was Ola Olajide, MD and facilitator Cynthia Jones, BS, CPHQ.

Quality Measure #1: Adjuvant Chemotherapy: Trastuzumab administered to patients with stage I-III

and HER2+ breast cancer who receive adjuvant chemotherapy. Results: 100% (n=72)

Quality Measure #2: Neoadjuvant Chemotherapy: Pertuzumab combined with trastuzumab and

docetaxel administered to patients with HER2+ locally advanced, inflammatory, or early-stage breast

cancer who receive neoadjuvant treatment. Results 96% (n=46)

Quality Measures #3: Metastatic Breast Cancer: HER2-directed therapy (trastuzumab, pertuzumab in

combination with trastuzumab, ado-trastuzumab emtansine, or lapatinib) administered to patients with

metastatic HER2+ breast cancer. Results = 89%* (n=9) *1 study outlier- pt not suitable for HER2

directed chemo due to age (>90) and severe /end stage comorbidities.Care medically appropriate.

Outcome: Service found to deliver highly concordant evidence based care to HER2+ breast cancer

patients as studied at current Adjuvant, Neoadjuvant and Metastatic current therapies.

o Secondary opportunities were identified in communication of existing performance measures -

status and expanded education on quality study methods and techniques.

UNC REX and the Dept of Surgey utilized Lean Methodology and Express Workout to study

Surgical Specimens handling and processing. The study was an opportunity to identify root causes

that lead to variables in labeling, handling and transport of crucial surgical specimens. The

importance of utilzing GEMBA and LEAN, Value Stream Mapping was to demonstrate the actual

processes in a neutral and blame free environment. Preventable gaps in optimal surgical specimen

handling can lead to delays and errors downstream. Dedicated participants included point of care

subject matter experts from surgical techs, laboratory, EPIC, and surgeons and pathologists. Baseline

data showed 5 specimen issues and 0.8% labeling variables for the year.

For reference: College of American Pathologists (CAP) Q-Probe rates of mislabeled specimens were

0.39/1000 in 120 institutions (2006).

Study sponsor was Linda Butler, MD, CMO and facilitator Kristen Wu,MSN, NP-C.

Outcomes: Key variables were identified in Process Variation, Technology, Culture, Communication

and Inventory management and availability. The team developed key actions to correct high impact

variables and standardize processes.

Immediate improvements were demonstrated with key actions. Additional actions are in completion

with supportive monitoring for continious quality improvement.

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Clinical Research Accrual ~ 2018

Type of Research Study

Clinical Trials

Diagnostic Trials

Genetic Studies

Prevention & Control Research Studies

Bio-Repository & Bio-Bank Studies

Patient Registry Studies

Other Not Specified (NOPR)

Quality of Life & Economics of Care

Percent Enrolled 8%

With the collective help of our doctors and cancer patients who choose to participate, clinical trials enable testing

of the latest research findings from the National Cancer Institute (NCI) and other research organizations. These

trials can take several years to complete, but the knowledge gained has led to an increase in the number of people

who survive cancer.

UNC REX Cancer Care participates in ongoing cancer clinical trials, including many in collaboration with UNC’s

Lineberger Comprehensive Cancer Center.

Available clinical trials include bio-banking and diagnostic studies, therapeutic trials, quality-of-life and support-

ive care trials.

UNC REX Cancer Research and Clinical Trials

Clinical research advances science and

ensures that patient care approaches

the highest level of quality

UNC REX is proud to perform at CoC

Commendation Level Patient Accrual

Percent at 8%

For reference: minimum required rate is

4% for Comprehensive Community Can-

cer Programs (CCCP)

To learn about clinical trials offered by UNC REX Cancer Care, or your eligibility

Call 919-784-7209 http://www.rexhealth.com/rh/care-treatment/clinical-trials/cancer/

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Comprehensive Community Cancer Care

UNC REX Cancer Care provides patients of Wake County and surrounding communities with exceptional cancer

care, including access to innovative treatments and support services. As the first nationally accredited Comprehensive

Community Cancer Center in North Carolina, we provide expert care, close to home, in several convenient locations.

In collaboration with UNC Lineberger Comprehensive Cancer Center, our physicians also access the latest in clinical

trials. Our physicians are at the helm of ongoing cancer research.

Multidisciplinary care is the heart of our program. Our board-certified physicians meet regularly and work together

as a team to develop a comprehensive treatment plan tailored to our patients’ needs.

UNC REX Cancer Care includes:

REX Hematology Oncology Associates

o Raleigh – Main Campus, Raleigh - Blue Ridge, East Raleigh, Cary, Garner, Wakefield

UNC REX Radiation Oncology

o Raleigh-Main Campus, East Raleigh, Clayton, Smithfield, Wakefield

UNC REX Surgical Oncology – North Carolina Surgery

o REX Surgical Specialists

Raleigh, Knightdale, Garner, Wakefield

o REX Thoracic Surgical Specialists

o REX Neurosurgery and Spine Specialists

Raleigh, Cary

UNC REX Pulmonary Specialists

o Raleigh, Holly Springs, Wakefield, Cary

UNC REX Gynecologic Oncology

UNC REX Comprehensive Breast Care Program

UNC REX Cancer Genetics Program

We also provide patients and their families with access to oncology support services, including:

Patient Navigation Financial Counseling

Clinical Trials Educational Programs

Cancer Rehabilitation Support Groups

High Risk Nutritional Management Survivorship Support

Social Work and Psychosocial Support Wellness Services

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UNC REX Cancer Care Locations

REX HEMATOLOGY AND ONCOLOGY ASSOCIATES

RALEIGH – Main Campus Raleigh -BLUE RIDGE CARY

4420 Lake Boone Trail 2605 Blue Ridge Road Parkway Professional Park

Suite 200 Suite 190 150 Parkway Court, Suite 200

Raleigh, NC 27607 Raleigh, NC 27607 Cary, NC 27518

T: 919-784-6818 T: 919-784-6060 T: 984-974-2150

F: 919-784-6826 F: 919-784-6061 F: 984-974-2151

WAKEFIELD GARNER EAST RALEIGH

11200 Governor Manly Way 300 Health Park Drive 117 Sunnybrook Road

Suite 102 Suite 220 Raleigh, NC 27610

Raleigh, NC 27614 Garner, NC 27529 T: 919-334-3900

T: 919-570-7550 T: 919-250-5955 F: 919-250-9280

F: 919-570-7551 F: 919-250-5954

UNC REX RADIATION ONCOLOGY

RALEIGH WAKEFIELD EAST RALEIGH

4420 Lake Boone Trail 11200 Governor Manly Way 117 Sunny Brook Road

Suite 100 Suite 102 Raleigh, NC 27610

Raleigh, NC 27607 Raleigh, NC 27614 T: 919-334-3900

T: 919-784-3018 T: 919-570-7550 F: 919-250-9280

F: 919-784-1473 F: 919-570-7551

CLAYTON RADIATION ONCOLOGY SMITHFIELD RADIATION ONCOLOGY

Johnston Professional Plaza Johnston Medical Mall

2076 Highway 42 West Suite 1200

Suite 120 514 N. Bright Leaf Boulevard

Clayton, NC 27520 Smithfield, NC 27577

T: 919-585-8550 T: 919-209-3555

F: 919-585-5882 F: 919-938-7400

UNC REX BREAST CARE

REX BREAST CARE CENTER REX SURGICAL ASSOCIATES (Raleigh)

(Diagnostic Imaging) (Breast Surgery)

3100 Duraleigh Road, Suite 204 3100 Duraleigh Road, Suite 205

Raleigh, NC 27607 Raleigh, NC 27607

T: 919-784-6186 T: 919-784-7874

REX SURGICAL ASSOCIATES (Cary) REX SURGICAL ASSOCIATES (Wakefield)

300 Ashville Ave 11200 Governor Manly Way

Suite 240 REX Healthcare of Wakefield, Suite 208

Cary, NC 27518 Raleigh, NC 27614

T: 919-784-7874 T: 919-784-7874

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UNC REX Cancer Care Locations REX NEUROSURGERY AND SPINE SPECIALISTS

T: 919-784-1410 F: 919-784-1409

RALEIGH CARY

4207 Lake Boone Trail, Suite 220 1505 SW Cary Parkway, Suite 302

Raleigh, NC 27607 Cary, NC 27511

REX SURGICAL SPECIALISTS -NORTH CAROLINA SURGERY

T: 919-784-7874 F: 919-784-2708

RALEIGH GARNER

Medical Office Building 300 Health Park Drive

2800 Blue Ridge Road, Suite 300 Suite 110

Raleigh, NC 27607 Garner, NC 27529

KNIGHTDALE WAKEFIELD

6602 Knightdale Blvd, Suite 201 11200 Governor Manly Way, Suite 208

Knightdale, NC 27545 Raleigh, NC 27614

REX THORACIC SURGICAL SPECIALISTS

RALEIGH

4420 Lake Boone Trail

Suite 100

Raleigh, NC 27607

T: 919-784-5650

REX PULMONARY SPECIALISTS

RALEIGH T: 919-784-7460 WAKEFIELD T: 919-784-7460

4414 Lake Boone Trail 11081 Forest Pines Drive

Suite 402 Suite 104

Raleigh, NC 27607 Raleigh, NC 27614

HOLLY SPRINGS T: 919-567-6230 CARY T: 984-974-9200

781 Avent Ferry Road 300 Ashville Avenue

REX Healthcare-Holly Springs, Suite 200 Suite 301

Holly Springs, NC 27540 Cary, NC 27518

UNC REX GYNECOLOGIC ONCOLOGY

4420 Lake Boone Trail Parkway Professional Park

Raleigh, NC 27607 150 Parkway Court, Suite 200

T: 919-784-6875 F: 919-784-6890 Cary, NC 27518

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A- REX Cancer Care- Main Campus

B - REX Hematology Oncology Associates – Wakefield

C - REX-UNC Radiation Oncology – Wakefield

D - REX Surgical Specialists – Wakefield

E - REX Hematology Oncology Associates – Cary

F - REX Thoracic Surgical Specialists - Cary

G - REX Neurosurgery & Spine Specialists – Cary

H - REX Hematology Oncology Associates – Garner

I - REX Surgical Specialists – Garner

J - UNC Radiation Oncology at Clayton

K - UNC Radiation Oncology at Smithfield

L - UNC REX Cancer Care of East Raleigh

For more information or to schedule an appointment with UNC

REX Cancer Care

For more information or to schedule

an appointment with

UNC REX Cancer Care

Call 919-784-3105

www.REXhealth.com

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UNC REX Cancer Center

4420 Lake Boone Trail

Raleigh, NC 27607

919-784-3105

www.REXhealth.com