Know Cancer

forgot password

Vaginal DHEA for Vaginal Symptoms: A Phase III Randomized, Double Blind, Placebo- Controlled Trial

Phase 3
18 Years
Open (Enrolling)

Thank you

Trial Information

Vaginal DHEA for Vaginal Symptoms: A Phase III Randomized, Double Blind, Placebo- Controlled Trial



- To determine the effectiveness of two doses of daily vaginal prasterone
(dehydroepiandrosterone [DHEA]) versus placebo for alleviation of the most bothersome
vaginal symptom (vaginal dryness or dyspareunia) over 12 weeks.


- To evaluate any toxicities arising from DHEA in this patient population. (Exploratory)

- To evaluate the impact of vaginal DHEA on negative sexual thoughts, sexual function and
urologic symptoms. (Exploratory)

- To explore the role of psychologic (mood, stress), physical (demographics and treatment
variables) and situational factors (partner variables and fatigue) as predictors of
vaginal dryness and performance outcomes at baseline and at various endpoints
throughout the study. (Exploratory)

- To explore the characteristics of vaginal atrophy and the relationship between vaginal
atrophy and quality-of-life questionnaire responses and exposure to hormonal therapy
(tamoxifen, exemestane, anastrozole, or letrozole). (Exploratory)

- To examine the effects of the use of open-label vaginal DHEA gel over 8 weeks in women
completing the placebo gel arm of the randomized trial. (Exploratory)

- To evaluate the impact of vaginal DHEA on maturation index and pH (select
institutions). (Correlative)

- To evaluate the impact of vaginal DHEA on sex steroid concentrations (estradiol, free
testosterone, estrone, and DHEA-S) and markers of bone turnover (osteocalcin and bone
alkaline phosphatase). (Correlative)

- To bank blood products for future studies. (Correlative)

OUTLINE: This is a multicenter study. Patients are stratified according to current tamoxifen
therapy (yes vs no), concurrent aromatase inhibitor (anastrozole/letrozole vs exemestane vs
none), hysterectomy (yes vs no), and cigarette smoking (current vs past vs never). Patients
are randomized to 1 of 3 treatment arms.

- Arm I: Participants apply a low dose of vaginal prasterone (dehydroepiandrosterone
[DHEA]) gel once daily (QD), at bed time, for 12 weeks.

- Arm II: Participants apply a high dose of vaginal DHEA gel QD, at bed time, for 12

- Arm III: Participants apply a vaginal placebo gel QD, at bed time, for 12 weeks.

- Optional Continuation Phase (for placebo arm only): Participants apply a high dose
of vaginal DHEA gel QD, at bed time, for 12 weeks.

Participants undergo blood sample collection at baseline and during weeks 11-12 for
estradiol, free testosterone, estrone, DHEA-sulfate, osteocalcin, and bone alkaline
phosphatase analysis. Some participants also undergo vaginal cells collection and vaginal pH

Participants may complete the Profile of Mood States (POMS), the Perceived Stress Scale
(PSS), the Fatigue: Vitality subscale of the SF-36, the Vaginal Symptom Quality
Questionnaire, the DHEA Side Effect Questionnaire, the Female Sexual Function Index (FSFI),
the Sexually Related Intrusive Thoughts - ITS, Impact of Treatment Scale, the Urogenital
Atrophy Questionnaire, and the Subject Global Impression of Change at baseline and
periodically during study.

Inclusion Criteria


- Postmenopausal women with a history of breast or gynecologic cancer (currently no
evidence of disease)

- Postmenopausal status determined by the following criteria:

- 12 months without a period or bilateral oophorectomy or complete chemical
ovarian suppression for the past 12 months with continued suppression
planned throughout the course of the study

- FSH and an estradiol value in the postmenopausal range (generally FSH >40
IU/L and estradiol < 10 pg/mL, depending on laboratory) if 9 months without
a period OR post hysterectomy with at least one ovary remaining and less
than 55 years old

- For age 55 or older, menopausal status does not need to be determined by
laboratory exams

- Significant vaginal complaints defined as persistent vaginal dryness and/or pain with
intercourse (dyspareunia) of sufficient severity to make a patient desire therapeutic

- Eligibility questionnaire response must be moderate or worse levels of severity on
one of the two symptoms, either dryness or dyspareunia

- Vaginal symptoms must have been present ≥ 2 months prior to randomization


- Life expectancy > 12 months

- ECOG performance status 0 or 1

- Ability to complete questionnaires by themselves or with assistance

- Willing to return to NCCTG enrolling institution for follow-up

- Willing to provide blood samples for correlative research purposes

- Willing to undergo brief pelvic exam at baseline and week 11-12, if institution
participating in that portion of the study

- No current diagnosis of an active vaginal infection; if symptoms of vaginal infection
(i.e., foul discharge, fever) present, then infection must be ruled out

- No diagnosis of any of the following conditions within the past five years:

- Essential vulvodynia

- Vulvar vestibulitis

- Bartholin cyst/abscess

- History of Bartholin gland surgery

- Lichen sclerosis

- Lichen planus of the vulvovaginal region

- Desquamative vaginitis

- No history or current diagnosis of any of the following conditions (ever):

- Vulvar or vaginal dysplasia

- Vaginal prolapse

- No women of childbearing potential or premenopausal women


- No initiation or discontinuation of tamoxifen or aromatase inhibitors ≤ 2 months
prior to randomization or plan to initiate or discontinue any of these medications
during the 12-week study

- No concurrent chemotherapy

- Long-term adjuvant trastuzumab, lapatinib, and/or bevacizumab is allowed

- Not planning to use any vaginal preparations during the study period (including any
over-the-counter or herbal preparations)

- Water-based lubricants, such as KY jelly, are allowed during sexual intercourse

- No use of any daily non-hormonal vaginal preparations ≤ 1 week prior to study entry

- Patients who stop agent may be enrolled after 1 week

- More then 4 weeks since prior and no concurrent use of any estrogen product or any
kind of hormonal vaginal product including bio-identical hormones, estriol, or any
androgen product

- No concurrent pharmacologic soy or phytoestrogen preparations (dietary intake of soy
[i.e., soy milk] is acceptable)

- Not on a placebo-controlled trial for endocrine therapy

- No prior or concurrent pelvic radiotherapy

- No prior radical pelvic surgery, specifically vaginectomy or pelvic exenteration

- Prior total abdominal hysterectomy (TAH) and/or bilateral salpingo-oophorectomy
(BSO) allowed

Type of Study:


Study Design:

Allocation: Randomized, Masking: Double-Blind, Primary Purpose: Supportive Care

Outcome Measure:

Alleviation of the most bothersome vaginal symptom (vaginal dryness or dyspareunia) over 12 weeks

Safety Issue:


Principal Investigator

Debra Barton, RN, PhD, AOCN, FAAN

Investigator Role:

Principal Investigator

Investigator Affiliation:

Mayo Clinic


United States: Food and Drug Administration

Study ID:




Start Date:

July 2011

Completion Date:

Related Keywords:

  • Cancer
  • depression
  • anxiety disorder
  • cognitive/functional effects
  • sexual dysfunction
  • cancer survivor
  • breast cancer
  • cervical cancer
  • fallopian tube cancer
  • uterine sarcoma
  • vaginal cancer
  • vulvar cancer
  • ovarian epithelial cancer
  • ovarian germ cell tumor
  • ovarian sarcoma
  • ovarian stromal cancer
  • primary peritoneal cavity cancer
  • endometrial cancer



Mayo Clinic Scottsdale Scottsdale, Arizona  85259
Mayo Clinic - Jacksonville Jacksonville, Florida  32224
Mayo Clinic Cancer Center Rochester, Minnesota  55905
CCOP - Upstate Carolina Spartanburg, South Carolina  29303
CCOP - Wichita Wichita, Kansas  67214-3882
Hurley Medical Center Flint, Michigan  48503
CCOP - Missouri Valley Cancer Consortium Omaha, Nebraska  68131
CCOP - Illinois Oncology Research Association Peoria, Illinois  61602
CCOP - Carle Cancer Center Urbana, Illinois  61801
CCOP - Iowa Oncology Research Association Des Moines, Iowa  50309-1016
CCOP - Metro-Minnesota Saint Louis Park, Minnesota  55416
Aurora Presbyterian Hospital Aurora, Colorado  80012
Boulder Community Hospital Boulder, Colorado  80301-9019
Penrose Cancer Center at Penrose Hospital Colorado Springs, Colorado  80933
CCOP - Colorado Cancer Research Program Denver, Colorado  80224-2522
Porter Adventist Hospital Denver, Colorado  80210
Presbyterian - St. Luke's Medical Center Denver, Colorado  80218
St. Joseph Hospital Denver, Colorado  80218
Rose Medical Center Denver, Colorado  80220
Swedish Medical Center Englewood, Colorado  80110
Sky Ridge Medical Center Lone Tree, Colorado  80124
Hope Cancer Care Center at Longmont United Hospital Longmont, Colorado  80502
St. Mary - Corwin Regional Medical Center Pueblo, Colorado  81004
North Suburban Medical Center Thornton, Colorado  80229
Saint Anthony Memorial Health Centers Michigan City, Indiana  46360
Cedar Rapids Oncology Associates Cedar Rapids, Iowa  52403
Mercy Medical Center - Sioux City Sioux City, Iowa  51104
Siouxland Hematology-Oncology Associates, LLP Sioux City, Iowa  51101
St. Luke's Regional Medical Center Sioux City, Iowa  51104
CCOP - Michigan Cancer Research Consortium Ann Arbor, Michigan  48106
Saint Joseph Mercy Cancer Center Ann Arbor, Michigan  48106-0995
Oakwood Cancer Center at Oakwood Hospital and Medical Center Dearborn, Michigan  48123-2500
Genesys Hurley Cancer Institute Flint, Michigan  48503
Van Elslander Cancer Center at St. John Hospital and Medical Center Grosse Pointe Woods, Michigan  48236
Sparrow Regional Cancer Center Lansing, Michigan  48912-1811
St. John Macomb Hospital Warren, Michigan  48093
MeritCare Bemidji Bemidji, Minnesota  56601
Fairview Ridges Hospital Burnsville, Minnesota  55337
Mercy and Unity Cancer Center at Mercy Hospital Coon Rapids, Minnesota  55433
CCOP - Duluth Duluth, Minnesota  55805
Miller - Dwan Medical Center Duluth, Minnesota  55805
Fairview Southdale Hospital Edina, Minnesota  55435
Mercy and Unity Cancer Center at Unity Hospital Fridley, Minnesota  55432
Hutchinson Area Health Care Hutchinson, Minnesota  55350
HealthEast Cancer Care at St. John's Hospital Maplewood, Minnesota  55109
Hennepin County Medical Center - Minneapolis Minneapolis, Minnesota  55415
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital Minneapolis, Minnesota  55407
St. Francis Cancer Center at St. Francis Medical Center Shakopee, Minnesota  55379
Park Nicollet Cancer Center St. Louis Park, Minnesota  55416
Regions Hospital Cancer Care Center St. Paul, Minnesota  55101
United Hospital St. Paul, Minnesota  55102
Ridgeview Medical Center Waconia, Minnesota  55387
MeritCare Broadway Fargo, North Dakota  58122
CCOP - MeritCare Hospital Fargo, North Dakota  58122
Geisinger Medical Group - Scenery Park State College, Pennsylvania  16801
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center Wilkes-Barre, Pennsylvania  18711
Sanford Cancer Center at Sanford USD Medical Center Sioux Falls, South Dakota  57117-5039
Avera Cancer Institute Sioux Falls, South Dakota  57105
Methodist Medical Center of Illinois Peoria, Illinois  61636
Memorial Hospital of South Bend South Bend, Indiana  46601
CCOP - Cancer Research for the Ozarks Springfield, Missouri  65807
CCOP - Montana Cancer Consortium Billings, Montana  59101
CCOP - Columbus Columbus, Ohio  43206
CCOP - Dayton Kettering, Ohio  45429
Hinsdale, Illinois  60521
CCOP - Northern Indiana CR Consortium South Bend, Indiana  46601
Saint Joseph Regional Medical Center South Bend, Indiana  46617
CCOP - Columbia River Oncology Program Portland, Oregon  97225
Cancer Research Center of Hawaii Honolulu, Hawaii  96813
John Stoddard Cancer Center at Iowa Methodist Medical Center Des Moines, Iowa  50309
St. Vincent Mercy Medical Center Toledo, Ohio  43608
Hulston Cancer Center at Cox Medical Center South Springfield, Missouri  65807
St. John's Regional Health Center Springfield, Missouri  65804
CCOP - Toledo Community Hospital Toledo, Ohio  43623-3456
University of Florida Shands Cancer Center Gainesville, Florida  32610-0232
Via Christi Cancer Center at Via Christi Regional Medical Center Wichita, Kansas  67214
Medical University of Ohio Cancer Center Toledo, Ohio  43614
Toledo Hospital Toledo, Ohio  43606
St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54307-3508
Green Bay Oncology, Limited - Escanaba Escanaba, Michigan  49431
Dickinson County Healthcare System Iron Mountain, Michigan  49801
St. Mary's Hospital Medical Center - Green Bay Green Bay, Wisconsin  54303
Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center Green Bay, Wisconsin  54301-3526
Green Bay Oncology, Limited at St. Mary's Hospital Green Bay, Wisconsin  54303
Bay Area Cancer Care Center at Bay Area Medical Center Marinette, Wisconsin  54143
Green Bay Oncology, Limited - Oconto Falls Oconto Falls, Wisconsin  54154
Green Bay Oncology, Limited - Sturgeon Bay Sturgeon Bay, Wisconsin  54235
North Colorado Medical Center Greeley, Colorado  80631
McKee Medical Center Loveland, Colorado  80539
Hematology-Oncology Centers of the Northern Rockies - Billings Billings, Montana  59101
St. Peter's Hospital Helena, Montana  59601
Kalispell Regional Medical Center Kalispell, Montana  59901
Montana Cancer Center at St. Patrick Hospital and Health Sciences Center Missoula, Montana  59802
Montana Cancer Specialists at Montana Cancer Center Missoula, Montana  59802
Adena Regional Medical Center Chillicothe, Ohio  54601
Doctors Hospital at Ohio Health Columbus, Ohio  43228
Riverside Methodist Hospital Cancer Care Columbus, Ohio  43214
Grady Memorial Hospital Delaware, Ohio  43015
Fairfield Medical Center Lancaster, Ohio  43130
Strecker Cancer Center at Marietta Memorial Hospital Marietta, Ohio  45750
Licking Memorial Cancer Care Program at Licking Memorial Hospital Newark, Ohio  43055
Community Hospital of Springfield and Clark County Springfield, Ohio  45505
Genesis - Good Samaritan Hospital Zanesville, Ohio  43701
University of New Mexico Cancer Center Albuquerque, New Mexico  87131-5636
Dakota Cancer Institute at Dakota Clinic - South University Fargo, North Dakota  58103-4940
Geisinger Cancer Institute at Geisinger Health Danville, Pennsylvania  17822-0001
Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
Elkhart General Hospital Elkhart, Indiana  46515
Howard Community Hospital Kokomo, Indiana  46904
Lakeland Regional Cancer Care Center - St. Joseph St. Joseph, Michigan  49085
Mount Carmel Health - West Hospital Columbus, Ohio  43222
Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest Allentown, Pennsylvania  18105
Front Range Cancer Specialists Fort Collins, Colorado  80528
Poudre Valley Hospital Fort Collins, Colorado  80524
Saint Alphonsus Cancer Care Center at Saint Alphonsus Regional Medical Center Boise, Idaho  83706
St. Joseph Medical Center Bloomington, Illinois  61701
Eureka Community Hospital Eureka, Illinois  61530
BroMenn Regional Medical Center Normal, Illinois  61761
Community Cancer Center Normal, Illinois  61761
Community Hospital of Ottawa Ottawa, Illinois  61350
Oncology Hematology Associates of Central Illinois, PC - Ottawa Ottawa, Illinois  61350
Cancer Treatment Center at Pekin Hospital Pekin, Illinois  61554
Oncology Hematology Associates of Central Illinois, PC - Peoria Peoria, Illinois  61615
OSF St. Francis Medical Center Peoria, Illinois  61637
Proctor Hospital Peoria, Illinois  61614
Illinois Valley Community Hospital Peru, Illinois  61354
Center for Cancer Therapy at LaPorte Hospital and Health Services La Porte, Indiana  46350
Bettendorf, Iowa  52722
Mercy Regional Cancer Center at Mercy Medical Center Cedar Rapids, Iowa  52403
John Stoddard Cancer Center at Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
Medical Oncology and Hematology Associates at John Stoddard Cancer Center Des Moines, Iowa  50309
Medical Oncology and Hematology Associates at Mercy Cancer Center Des Moines, Iowa  50314
Mercy Cancer Center at Mercy Medical Center - Des Moines Des Moines, Iowa  50314
Medical Oncology and Hematology Associates - West Des Moines West Des Moines, Iowa  50266
Cancer Center of Kansas, PA - Dodge City Dodge City, Kansas  67801
Hickman Cancer Center at Bixby Medical Center Adrian, Michigan  49221
Community Cancer Center of Monroe Monroe, Michigan  48162
St. Joseph's Medical Center Brainerd, Minnesota  56401
Coborn Cancer Center Saint Cloud, Minnesota  56303
CentraCare Clinic - River Campus St. Cloud, Minnesota  56303
Immanuel Medical Center Omaha, Nebraska  68122
Creighton University Medical Center Omaha, Nebraska  68131-2197
Wood County Oncology Center Bowling Green, Ohio  43402
Samaritan North Cancer Care Center Dayton, Ohio  45415
Grandview Hospital Dayton, Ohio  45405
David L. Rike Cancer Center at Miami Valley Hospital Dayton, Ohio  45409
Good Samaritan Hospital Dayton, Ohio  45406
Blanchard Valley Medical Associates Findlay, Ohio  45840
Charles F. Kettering Memorial Hospital Kettering, Ohio  45429
Lima Memorial Hospital Lima, Ohio  45804
Northwest Ohio Oncology Center Maumee, Ohio  43537
Middletown Regional Hospital Middletown, Ohio  45044
Toledo Clinic - Oregon Oregon, Ohio  43616
St. Charles Mercy Hospital Oregon, Ohio  43616
Mercy Hospital of Tiffin Tiffin, Ohio  44883
Toledo Clinic, Incorporated - Main Clinic Toledo, Ohio  43623
UVMC Cancer Care Center at Upper Valley Medical Center Troy, Ohio  45373-1300
Fulton County Health Center Wauseon, Ohio  43567
Ruth G. McMillan Cancer Center at Greene Memorial Hospital Xenia, Ohio  45385
Providence Milwaukie Hospital Milwaukie, Oregon  97222
Providence Cancer Center at Providence Portland Medical Center Portland, Oregon  97213-2967
Providence St. Vincent Medical Center Portland, Oregon  97225
Bon Secours St. Francis Health System Greenville, South Carolina  29601
Southwest Washington Medical Center Cancer Center Vancouver, Washington  98668
Holy Family Memorial Medical Center Cancer Care Center Manitowoc, Wisconsin  54221-1450
Welch Cancer Center at Sheridan Memorial Hospital Sheridan, Wyoming  82801
St. Anthony Central Hospital Denver, Colorado  80204-1335
Exempla Lutheran Medical Center Wheat Ridge, Colorado  80033
Cancer Resource Center - Lincoln Lincoln, Nebraska  68510
Altru Cancer Center at Altru Hospital Grand Forks, North Dakota  58201
Herbert D. Kerman Regional Oncology Center - Daytona Beach Daytona Beach, Florida  32114
Michiana Hematology-Oncology, PC - Elkhart Elkhart, Indiana  46514
Elkhart Clinic, LLC Elkhart, Indiana  46514-2098
Michiana Hematology Oncology PC - La Porte La Porte, Indiana  46350
Michiana Hematology-Oncology, PC - South Bend Mishawaka, Indiana  46545-1470
Michiana Hematology Oncology PC - Plymouth Plymouth, Indiana  46563
Reid Hospital & Health Care Services Richmond, Indiana  47374
Cancer Center of Kansas, PA - Chanute Chanute, Kansas  66720
Cancer Center of Kansas, PA - El Dorado El Dorado, Kansas  67042
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Cancer Center of Kansas, PA - Kingman Kingman, Kansas  67068
Lawrence Memorial Hospital Lawrence, Kansas  66044
Cancer Center of Kansas, PA - Liberal Liberal, Kansas  67905
Cancer Center of Kansas, PA - Newton Newton, Kansas  67114
Cancer Center of Kansas, PA - Parsons Parsons, Kansas  67357
Cancer Center of Kansas, PA - Pratt Pratt, Kansas  67124
Cancer Center of Kansas, PA - Salina Salina, Kansas  67401
Cancer Center of Kansas, PA - Wellington Wellington, Kansas  67152
Cancer Center of Kansas, PA - Wichita Wichita, Kansas  67214
Associates in Womens Health, PA - North Review Wichita, Kansas  67208
Cancer Center of Kansas, PA - Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas, PA - Winfield Winfield, Kansas  67156
Foote Memorial Hospital Jackson, Michigan  49201
St. Mary Mercy Hospital Livonia, Michigan  48154
Mercy Memorial Hospital - Monroe Monroe, Michigan  48162
St. Joseph Mercy Oakland Pontiac, Michigan  48341-2985
Mercy Regional Cancer Center at Mercy Hospital Port Huron, Michigan  48060
Seton Cancer Institute at Saint Mary's - Saginaw Saginaw, Michigan  48601
Lakeside Cancer Specialists, PLLC Saint Joseph, Michigan  49085
Willmar Cancer Center at Rice Memorial Hospital Willmar, Minnesota  56201
Billings Clinic - Downtown Billings, Montana  59107-7000
Bozeman Deaconess Cancer Center Bozeman, Montana  59715
St. James Healthcare Cancer Care Butte, Montana  59701
Alegant Health Cancer Center at Bergan Mercy Medical Center Omaha, Nebraska  68124
Grant Medical Center Cancer Care Columbus, Ohio  43215
Hematology Oncology Center Elyria, Ohio  44035
Community Cancer Center Elyria, Ohio  44035
Wayne Hospital Greenville, Ohio  45331
Knox Community Hospital Mount Vernon, Ohio  43050
Flower Hospital Cancer Center Sylvania, Ohio  43560
St. Anne Mercy Hospital Toledo, Ohio  43623
Mount Carmel St. Ann's Cancer Center Westerville, Ohio  43081
Lehigh Valley Hospital - Muhlenberg Bethlehem, Pennsylvania  18017
Geisinger Hazleton Cancer Center Hazleton, Pennsylvania  18201
Fredericksburg Oncology, Incorporated Fredericksburg, Virginia  22401
Rocky Mountain Oncology Casper, Wyoming  82609
Genesys Regional Medical Center Grand Blanc, Michigan  48439-8066
Queen's Cancer Institute at Queen's Medical Center Honolulu, Hawaii  96813
Rutherford Hospital Rutherfordton, North Carolina  28139
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center Spartanburg, South Carolina  29303
Galesburg Clinic, PC Galesburg, Illinois  61401
St. Vincent Healthcare Cancer Care Services Billings, Montana  59101
Kapiolani Medical Center at Pali Momi Aiea, Hawaii  96701
Kapiolani Medical Center for Women and Children Honolulu, Hawaii  96826
Straub Clinic and Hospital, Incorporated Honolulu, Hawaii  96813
Hawaii Medical Center - East Honolulu, Hawaii  96817
OnCare Hawaii, Incorporated - Kuakini Honolulu, Hawaii  96817
OnCare Hawaii, Incorporated - Lusitana Honolulu, Hawaii  96813
Maui Memorial Medical Center Wailuku, Hawaii  96793
Pacific Cancer Institute - Maui Wailuku, Hawaii  96793
Illinois CancerCare - Bloomington Bloomington%, Illinois  61701
Illinois CancerCare - Canton Canton, Illinois  61520
Illinois CancerCare - Carthage Carthage, Illinois  62321
Illinois CancerCare - Eureka Eureka, Illinois  61530
Illinois CancerCare - Havana Havana, Illinois  62644
Illinois CancerCare - Kewanee Clinic Kewanee, Illinois  61443
Illinois CancerCare - Macomb Macomb, Illinois  61455
Trinity Cancer Center at Trinity Medical Center - 7th Street Campus Moline, Illinois  61265
OSF Holy Family Medical Center Monmouth, Illinois  61462
Illinois CancerCare - Monmouth Monmouth, Illinois  61462
Illinois CancerCare - Community Cancer Center Normal, Illinois  61761
Illinois CancerCare - Pekin Pekin, Illinois  61603
Illinois CancerCare - Peru Peru, Illinois  61354
Illinois CancerCare - Princeton Princeton, Illinois  61356
Illinois CancerCare - Spring Valley Spring Valley, Illinois  61362
United States Air Force Medical Center - Wright-Patterson Wright-Patterson AFB, Ohio  45433-5529
AnMed Cancer Center Anderson, South Carolina  29621
Franciscan Skemp Healthcare - La Crosse Campus La Crosse, Wisconsin  54601
Lovelace Medical Center - Downtown Albuquerque, New Mexico  87102
Immanuel St. Joseph's Mankato, Minnesota  56002
Minnesota Oncology - Maplewood Maplewood, Minnesota  55109
Humphrey Cancer Center at North Memorial Outpatient Center Robbinsdale, Minnesota  55422-2900
Lakeview Hospital Stillwater, Minnesota  55082
Minnesota Oncology - Woodbury Woodbury, Minnesota  55125
Northwest Cancer Specialists at Vancouver Cancer Center Vancouver, Washington  98684
Castle Medical Center Kailua, Hawaii  96734
Kauai Medical Clinic Lihue, Hawaii  96766
Lakeside Hospital Omaha, Nebraska  68130
Presbyterian Cancer Treatment Center at Presbyterian Kaseman Hospital Albuquerque, New Mexico  87110
University of New Mexico Cancer Center - South Las Cruces, New Mexico  88011
Clackamas Radiation Oncology Center Clackamas, Oregon  97015
Providence Newberg Medical Center Newberg, Oregon  97132
Willamette Falls Hospital Oregon City, Oregon  97045
Littleton Adventist Hospital Littleton, Colorado  80122
Parker Adventist Hospital Parker, Colorado  80138
New Ulm Medical Center New Ulm, Minnesota  56073
St. Nicholas Hospital Sheboygan, Wisconsin  53081
Southern Ohio Medical Center Cancer Center Portsmouth, Ohio  45662
Cancer Center of Kansas, PA - McPherson McPherson, Kansas  67460
Carolina Blood and Cancer Care Associates, PA Lancaster, South Carolina  29720
Carolina Blood and Cancer Care Rock Hill, South Carolina  29732
St. Francis Hospital Cancer Care Services Indianapolis, Indiana  46237
Mercy Clinic Cancer and Hematology - Rolla Rolla, Missouri  65401
Idaho Urologic Institute, PA Meridian, Idaho  83642
Mercy Cancer Center - West Lakes Clive, Iowa  50325
Methodist West Hospital West Des Moines, Iowa  50266-7700
Zangmeister Center Columbus, Ohio  43219
Benefis Sletten Cancer Institute Great Falls, Montana  59405
Essentia Health - Duluth Clinic Duluth, Minnesota  55805-1983