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What the Heck is a Cancer Registrar

What the Heck is a Cancer Registrar. Berna Glassman, CTR WY Cancer Surveillance Program. Introduction. Concept of describing disease by stage or extent introduced in 1929 by League of Nations’ World Health Organization First primary site so described was the cervix

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What the Heck is a Cancer Registrar

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  1. What the Heck is a Cancer Registrar Berna Glassman, CTR WY Cancer Surveillance Program

  2. Introduction • Concept of describing disease by stage or extent introduced in 1929 by League of Nations’ World Health Organization • First primary site so described was the cervix • Staging=shorthand method for grouping cases into broad categories based on disease extent • Primary tumor site, tumor size, number of tumors, depth of tumor invasion, involvement of lymph nodes and/or spread to distant sites (distant metastases) • Indicates type of treatments to use & prognosis

  3. What Is Cancer Registry? • Systematic collection about occurrence of cancer • Type of cancer • Extent of disease at time of diagnosis • Treatments • Outcomes of treatment • Quality of Medical care • Where do we begin? • Casefinding • Coding into into specialized database • Ultimate Goal • Prevent and control of Cancer!!!

  4. How It All Works

  5. Now, What the Heck is a Cancer Registrar? • Medical Healthcare Professional • Medical Coder • Cancer-Registry Software Expert • Public Relations Person • Educator • Detective • STUDENT!

  6. Why Would Anyone Want to be a Cancer Registrar? • Right Livelihood- support yourself without harming others • Challenging • Worthwhile • MAKING A POSITIVE DIFFERENCE!

  7. Sample Case ScenarioThe Story • Michael Mouse, aka Mickey--76-yr old married, white male, retired actor, lives in Jackson, WY. Presented to St. John’s Hospital w/ chief complaint of frequent & urgent urination (3-4x/night). Mickey’s PSA was elevated at 22.5 (normal range 0-4). Mickey’s H&P were basically unremarkable. He is in excellent health for a gentleman of his age. A prostate nodule was detected on digital rectal exam (DRE). Mickey agreed to needle biopsies of his prostate. Needle bxs indicated that both prostatic lobes were involved with invasive adenocarcinoma. Treatment options were discussed. Mickey agreed to hormone therapy followed by radical prostatectomy. The prostate gland was removed. The 6 lymph nodes dissected were negative, as were the surrounding tissues & surgical margins. Via CT scans, a metastatic work up was performed to determine the extent of his disease. All scans were negative. Mickey’s disease was confined to his prostate gland with no evidence of disease spread.

  8. Summary of the Story • Staging • T2-tumor involvement - both prostate lobes • N0-lymph node involvement - none • M0-Metastases to bones and/or distant organs – none • T2 N0 M0- tumor involvement in both lobes; ln neg; no evid mets • Stage 2, Local Disease • Treatment • Hormone Treatment followed by • Radical Retropubic Prostatectomy w/6 lymph nodes sampled • Outcome • Patient is Alive • Cancer Status is No Evidence of Disease (NED) • Good Prognosis!

  9. The Cancer Abstract – Part 1 • Patient Information (Demographics) • MOUSE, MICHAEL WALTER aka MOUSE MICKEY CTR #: 10000314-00 • Hos #1 ST. JOHN'S HOSPITAL Hosp. #231-200500010-00 • Admit: 01/10/2005 CC:1 DX / RX • Chart: 2310010 Acc Yr:2005 Payer:60 (Medicare/Medicade) Abs:BLG • Reporting Source: 1 HOSPITAL-IN Follow-up Hospital: 1 • SSN: 987-65-4321 Sex : 1 MALE Date of Birth: 04/15/1928 • ADDR AT DX: 444 FRIENDSHIP BLVD JACKSON WY 83331 • FU ADDRESS: PO BOX 1234 JACKSON WY 83331 • Marital St:2 MARRIED Place of Birth: 097(Calif) Age at Dx: 76 yrs • Race: 010 WHITE; non Hispanic County: 039 TETON • Occupation: ACTOR • Industry: WALT DISNEY ENTERPRISES

  10. The Cancer Abstract – Part 2 • Disease Specific Information • Date of Dx: 01/01/2005 Histology(2): 81403 ADENOCARCINOMA • GRADE: II MOD DIFF. Hist-3: 81403 ADENOCARCINOMA • Site: C619 PROSTATE Stage: Stg-2000: • Paired Organ:0 NOT PAIRED ORGAN Diag. Conf.: 1 HISTOLOGY • Tumor Size: 999 mm. Positive Nodes: 00 Nodes Examined: 08 • Clinical: TNM: AJCC Stage: Staged by: NOT STAGED • Pathological: TNM: AJCC Stage: Staged by: NOT STAGED • Sites of Distant Metastasis: 0 NONE 0 NONE 0 NONE

  11. The Cancer Abstract – Part 3 • Best Treatments Code Date • DIAG/STG 00 00/00/0000 • SURG 50 03/10/2005 • RAD 0 00/00/0000 • CHEM 00 00/00/0000 • HORM 01 01/15/2005 • BRM 00 00/00/0000 • OTHER 0 00/00/0000 • Surgical Approach: 8 (retropubic) • 1st course: Scope LN Surg 0 Surg Other Site 0 Reg’l LN Examined 06 • Subseq Reconstruct Del: 0

  12. The Cancer Abstract – Part 4 • Follow Up Information Physicians 21436 ROLAND FLECK 24481 LISA J FINKELSTEIN 28231 ST. JOHN’S HOSPITAL Survival Time: 1 Yr. 9 Mon. Date Last Seen: 10/27/2006 Vital Status:1 (alive) Cancer Status: 1 (no evidence of disease)

  13. Acknowledgments • Cancer Registry Management Principles & Practices Hutchison, Roffers, Fritz (editors) • National Cancer Registrars Association (NCRA); Alexandria, Virginia • Diagnosis & Treatment Workgroup –WY Comprehensive Cancer Control Coalition • HIM & Cancer Registry Professionals Everywhere – • THANK YOU! • And now, • It’s Time to Go!

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