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

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Presentation on theme: "What the Heck is a Cancer Registrar Berna Glassman, CTR WY Cancer Surveillance Program."— Presentation transcript:

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 Scenario The Story Michael Mouse, aka Mickey--76-yr old married, white male, retired actor, lives in Jackson, WY. Presented to St. Johns Hospital w/ chief complaint of frequent & urgent urination (3- 4x/night). Mickeys PSA was elevated at 22.5 (normal range 0-4). Mickeys 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. Mickeys 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 #: Hos #1 ST. JOHN'S HOSPITAL Hosp. # Admit: 01/10/2005 CC:1 DX / RX Chart: Acc Yr:2005 Payer:60 (Medicare/Medicade) Abs:BLG Reporting Source: 1 HOSPITAL-IN Follow-up Hospital: 1 SSN: Sex : 1 MALE Date of Birth: 04/15/1928 ADDR AT DX: 444 FRIENDSHIP BLVD JACKSON WY FU ADDRESS: PO BOX 1234 JACKSON WY 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): ADENOCARCINOMA GRADE: II MOD DIFF. Hist-3: 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 Regl LN Examined 06 Subseq Reconstruct Del: 0

12 The Cancer Abstract – Part 4 Follow Up Information Physicians ROLAND FLECK LISA J FINKELSTEIN ST. JOHNS 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, Its Time to Go!

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