Category: cancer registrar

NCRA 2023 Conference

The 49th Annual Educational Conference hosted by the National Cancer Registrars Association (NCRA) will be held May 7-10, 2023 in San Diego at the Town and Country Resort. This year’s event will be a hybrid venue, i.e., live attendance with access to live streaming and on-demand sessions after the conference. Virtual attendees will be able to attend the live sessions and present questions online during the Q&A.

The conference will feature important cancer registry topics focusing on current issues and trends in the cancer registry profession. Registrars can earn up to 20+ continuing education (CE) credits to use in maintaining their credentials.

Why should you attend?

  1. Live attendees can experience one of the largest networking events in the world for cancer registrars.
  2. Earn 20 CE units for credential maintenance.
  3. Get important updates from the standard-setters.
  4. Learn about the newest advances in cancer treatment and oncology healthcare.
  5. Hear updates from your peers and subject matter experts.
  6. Have access to the virtual sessions for up to 2 months after the event.

Click on any of the links below to access conference registration, hotel and session information:

  1. Registration Brochure
  2. Online Registration
  3. Hotel, Travel and Transportation Information for Attendees
  4. Exhibitor Information
  5. CTR Exam Prep Workshop
  6. Fundamentals of Abstracting Workshop
  7. Danielle Chufar Memorial Annual Scholarship
  8. Top Things to Do in San Diego

Come “Sailing Towards New Horizons” with your friends and cancer registry professional association in May. Looking forward to seeing you in San Diego!

Acting on Your Calling

How did you find your calling in life? Florence Nightingale knew at a very young age she was being called as a nurse. Her family was not supportive and felt it to be beneath her station in life as a debutante in a wealthy and privileged society. She volunteered to work in a hospital to explore her dream. But her family bullied and punished her every step of the way. Struggling to make the most important decision of her life, she wrote to Dr. Samuel G. Howe asking for advice. He responded by saying, “…if you have a vocation for that way of life, act up to your inspiration and you will find there is never anything unbecoming or unladylike in doing your duty for the good of others. Choose, go on with it, wherever it may lead you.”
#CTR #cancerregistry #cancerregistrar #cancer #purpose #inspiration

Cancer Treatment & Survivor Statistics 2022

The number of cancer survivors is growing in the USA as a result of combined effects of a growing and aging population as well as advances in early detection and treatment. The American Cancer Society collaborates with the National Cancer Institute to estimate cancer prevalence in the US for the most common cancers. In the 2022 report statistics on contemporary treatment patterns and survival as well as issues related to survivorship and the COVID-19 pandemic are discussed. Then, for the first time, treatment data by race/ethnicity for a selected set of cancers (female breast, colon, rectum, lung and uterus) are also presented.

Information in this report can be very useful for cancer registrars and administrators for statistical comparison or to understand the unique characteristics of the population in your region.

Download the report here and share with your colleagues!

2023 Updates to ICD-O-3

8/22/2022 – NAACCR has released the 2023 updates to the ICD-O-3 histology and behavior codes. All Registrars, regardless of which type of facility, should become familiarw with the proposed changes and guidelines and coordinate with your software vendor updates to their software and edits metafiles.

To download the files (at no charge), click here ICD O 3 Coding Updates – NAACCR. Updates are available in PDF and Excel file formats. Code lists are available in numeric and alpha tables. Also available is an annotated histology list with descriptions. Be sure to read the Coding Guidelines document for the summary of changes and how updates will be implemented and the rationale for doing so.

Cancer A to Z

There are over 300 different types of cancer. A cancer registrar is specially trained in how to correctly gather the data from the medical record and to code and classify it for research and strategic planning. From time to time they will come across a type of cancer they may not be as familiar with as compared to cancers like lung, colon, prostate, breast, etc. Having a resource like this one published by the National Cancer Institute (NCI) is very helpful.

CoC Publishes Responses to NCRA Sessions Q&A

The American College of Surgeons (ACoS) presented several sessions at the National Cancer Registrar’s Association (NCRA) annual educational conference held on June 3-5, 2021. In response to the participant questions asked at each of these sessions, the ACoS has released a PDF with a written response to all the questions they received. You can view this document below.

Note: if you cannot see the PDF document, copy and paste this URL into your web browser: https://www.facs.org/-/media/files/quality-programs/cancer/ncra_meeting_qa.ashx.

ncra_meeting_qa

Survey – Imaging & cN Stage

Cancer staging is a fairly complex task and has many components and variables that cancer registrars must take into account. Let’s have some fun and test your knowledge about staging. To see survey results, scroll to the bottom of the post and click on “Statistics – View the Results” tab.

Please answer three questions in the short quiz below.

[perfect_survey id=”1325″]

What Are Cancer Statistics?

Cancer Registrars collect and analyze data to tell a story about the latest trends in their facility, region, state or nationally. Understanding how the statistics are derived and calculated, especially if you are going to compare your hospital with another program, state or national benchmark is very important.

SEER (Surveillance, Epidemiology and End Results) has made available a series of online videos called Did You Know? The video’s highlight key topics and trends and are helpful in understanding cancer-related statistics.

Here is one of these videos, titled “Cancer Statistics.”

Cancer Statistics | Did You Know? | Surveillance, Epidemiology and End Results (SEER)

When is CLL in Remission?

When is chronic lymphocytic leukemia (CLL) in remission? What does it mean when the medical record states the CLL patient has a complete or partial remission? All great questions often heard around the table when cancer registrars get together.

CLL is the most common type of leukemia in the United States in American adults. Over 175,000 men and women are currently living with CLL, and many of them with a good quality of life. While a cure is not yet available there are a wide-range of effective treatments available today. For patients with slow-growing disease or who are in clinical remission, they may not even require active therapy. Of course, Cancer Registrars will be looking for all of this information and coding it appropriately in the case abstract.

Standard treatment for CLL is chemotherapy and radiation. However, newer treatments are being tested and made available to patients to help them achieve partial and complete remission for longer and longer periods of time. Newer therapies include:

  • Immunotherapy:
    • Drugs that work with the body’s immune system to attack the cancer cells similar to how it attacks other diseases.
  • Chemotherapy:
    • Treatment regiments combined with stem cell transplant are being used to kill the cancerous cells in the body and are then replaced with healthy cells via a stem cell transplant.
  • Targeted Drugs:
    • These new medications attack specific substances that help the cancer cells to grow and multiply and leave the healthy, non-malignant cells alone.

There are two types CLL remission which we will describe below:

  • Complete:
    • If the patient’s blood tests no longer show the presence of CLL and they do not have any symptoms, such as swelling in the lymph nodes or spleen, then CLL is considered to be in complete remission.
  • Partial:
    • If the patient is symptom-free (i.e., no swelling in lymph nodes) but there is still a small amount of CLL detected in their blood tests, then they are considered to be in partial remission.

Laboratory tests are an important part of the medical record that the Cancer Registrar must review. For CLL you should look at the following:

  • Blood Testing
    • Diagnosing CLL usually starts with a routine blood test called complete blood count, or CBC. A CBC measures a number of different types of cells in the sample. For example, a patient may have CLL if the blood contains too many white blood cells, or WBCs. The CBC also measures red blood cells (RBCs) and platelets. Low levels of RBCs is called anemia and low platelet count is called thrombocytopenia.
  • Flow Cytometry and Cytochemistry
    • For these tests chemicals or dyes may be applied to the blood sample in the laboratory to provide information about the type and subtype of leukemia. CLL has distinctive markers, called cell surface proteins, on the outside of the cell. The pattern of these markers is called immunophenotype and is used to distinguish CLL from other types of leukemia that also involve lymphocytes. Flow cytometry, also called immunophenotyping, is the most important test used to confirm a diagnosis of CLL.
  • Genomic and Molecular Testing
    • These tests look for specific genes, proteins, chromosome changes or other factors unique to leukemia. Because CLL cells divide very slowly, looking at chromosomes is often less useful than tests that find specific genetic mutations or changes. Fluorescence in situ hybridization (or FISH) assays and other genetic tests, such as polymerase chain reaction, are used to find genetic mutations. Some of the genetic changes that are found in CLL include (but are not limited to):
      • Deletion of the long arm of chromosome 13 [del(13q)], which is found in about half of all CLL patients,
      • An extra copy of chromosome 12 (trisomy 12),
      • del(11q),
      • del(17p),
      • NOTCH1 mutations,
      • SF3B1 mutations,
      • TP53 abnormalities,
      • MYD88 mutations, and
      • IGVH, which may be important whether it is changed or unchanged.
    • Genomic and molecular testing can be used to determine how quickly the disease will progress and to identify treatment therapies and options. For example, if a patient has del(17p) genetic mutation then they are more likely to have a leukemia that is difficult to treat and some may work better than others.
  • Imaging
    • It is common for CLL to be found in many different parts of the body, even if diagnosed early. Imaging tests are rarely used to diagnose CLL but they may be used before treatment is given to identify areas of involvement or to determine how well CLL is responding to treatment.
  • Bone Marrow Aspiration and Biopsy
    • Bone marrow biopsy is also not generally used to diagnose CLL, but it may be done before treatment starts. It is useful to help determine the prognosis or a patient’s chance of recovery.

CLL can be in remission for many years, but there is always a chance it could come back. It is not uncommon for a physician to recommend a “watch and wait” form of long-term surveillance. This is why it is so important for the Cancer Registrar to understand the disease process and to gather accurate and complete follow-up and cancer status information throughout the patient’s lifetime.

Cancer Registrar’s should consult the SEER hematologic coding and abstracting resources to determine other steps or actions taken during the case abstraction process, whether they are in a SEER-designated State or not.

Disclaimer – this article is not used to determine coding or abstracting standrds! Rather it is an informational guide to help the Registrar understand what they may find in the medical record. For coding or abstracting standards please refer to your apppropriate manuals.

What Are Biomarkers?

Biomarkers, or biological markers, are molecules found in body tissues and fluids, including tissue and blood. Cancer biomarkers provide important information about the patient’s tumor. Biomarker terminology varies but it may also be called biomarker testing or tumor testing. Biomarkers are usually a protein or antibody that is released by the tumor, or they may be the body’s response to the presence of cancer, which shows up like a gene mutation. There are a number of biomarkers used by clinicians today and more are being studied.

When a clinician orders a biomarker study, they are looking to answer important questions about the patient’s disease that may include:

  • How aggressive is this cancer?
    • Prognostic biomarkers tell us about the estimated course, or progression, the cancer will take if it is not treated. These markers help to identify how well organized the cell is, or if it is not functioning at all.
  • What is the best drug to use to treat this cancer?
    • Predictive biomarkers are ordered to identify the best available treatment because they may preduct whether or not the cancer will respond to a specific treatment.
  • Will this cancer recur, or when will it come back?
    • Recurrence biomarkers may be used to monitor the presence of a cancer or whether it has recurred after initially responding to treatment.
  • What type of cancer does the patient have?
    • Diagnostic biomarkers aid in identifying the type of cancer a specific patient may have.
  • What is the correct dose of drugs needed to treat an individual patient?
    • Pharmacodynamic biomarkers are useful to determine the dose, usually chemotherapy, that will be given to the patient.

As you can see above, biomarker testing helps the clinician identify critical information needed to develop and deliver an effective plan of treatment. Testing should happen as close to the diagnosis as possible and before a treatment plan is launched.

Discussion of biomarker results or as a predictor for treatment or recurrence is included in multidisciplinary cancer conferences (aka tumor boards) and physician-to-patient discussions. Cancer Registrars gather biomarkers and include relevant values and their types in the cancer case abstract that is used for clinical research, quality studies and comparative analysis.

(Source: Biomarkers and Biomarker Testing, Fight Colorectal Cancer, Springfield, MO.)