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

What the Heck is a Cancer Registrar

Berna Glassman, CTRWY 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 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

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!!!

How It All Works

Nat’l Cancer RegistryState Cancer RegistryReg’l Cancer RegistryHospital Ca Registry

Outpatient ClinicsPhysician’s Offices

LaboratoriesRadiation Tx OfficesOutpt Surgical Ctrs.

Now, What the Heck is a Cancer Registrar?

Medical Healthcare Professional Medical Coder Cancer-Registry Software Expert Public Relations Person Educator Detective STUDENT!

Why Would Anyone Want to be a Cancer Registrar?

Right Livelihood- support yourself without harming others

Challenging Worthwhile MAKING A POSITIVE DIFFERENCE!

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.

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!

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

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

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

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)

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!