Cancer Cancer Annual Report
2015
2015 based on data compiled in 2014
Table of Contents Chairman's Report:.................................................................................................................................... 3 Thomas L. Eisenhauer, M.D., F.A.C.S.
Cancer Service Line Overview:.................................................................................................................. 4 James Bloodworth
Cancer Service Line - New Cancer Center:............................................................................................... 5 James Bloodworth
Cancer Liaison Physician Report:............................................................................................................. 6 John Hill, M.D.
A Snapshot of Breast Cancer Management in 2014:............................................................................... 6 W. Mark McCollough, M.D.
Cancer Incidences & Cases:....................................................................................................................... 8 Cancer Research Report:.......................................................................................................................... 10 James Radford, M.D.
The Growing Need for Survivorship Care:............................................................................................. 12 Kristy Capps, RN, CBPN-IC and Leann Noakes, RN, CCRP
Elizabeth Reilly Breast Center Update:................................................................................................... 14 Charles A. Albers, M.D., F.A.C.S.
Pardee Cancer Registry..................................................................................................................................................... 15 Carol P. Brown, ABA, CTR
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Chairman’s Report: The Comprehensive Cancer Center at Margaret R. Pardee Memorial Hospital had an excellent year in 2014. The program continued to grow in numbers of patients as well as the services offered to patients. It is exciting to lead this oncology program through the various stages of growth that it has been experiencing. Just a few of these enhancements are highlighted for you in this Annual Report. The Comprehensive Cancer Center at Margaret R. Pardee Memorial Hospital received a three-year accreditation from the American College of Surgeons Commission on Cancer during its 2012 certification survey. The accreditation process is a careful review of the entire scope of services Pardee has to offer for cancer patients in Henderson and the surrounding counties. The surveyor, who represents the American College of Surgeons and the Commission on Cancer, evaluates all aspects of cancer services at Pardee for the three years prior to the survey. This evaluation ensures the hospital being surveyed provides up-to-date cancer care, enrolls patients in national clinical trials for the advancement of cancer treatment, educates physicians and patients regarding cancer, and reports their cancer cases to the National Cancer Data Base. During this recent survey, Pardee excelled in all of these categories, receiving awards with commendation in each applicable category. The Commission on Cancer awarded Pardee’s efforts by naming the program an Outstanding Achievement Award recipient, one of only four in the state of North Carolina this year. Our program was surveyed again in the fall of 2015. The Elizabeth Reilly Breast Center continues to serve individuals with breast disease. Since its opening, the Breast Center has been assisting women with their breast care. The center provides patient education for breast self-examination, cancer risk assessment and cancer treatment options. The nurse navigator is available to help each patient schedule follow-up mammograms, arrange appointments with the appropriate physicians and prepare for surgical procedures. Patients report an overwhelmingly positive response to the services provided for this specific cancer. In conjunction with the overall cancer program survey by the Commission on Cancer, the breast center received another three-year accreditation from the National Accreditation Program for Breast Centers. The weekly Cancer Conferences provide a forum where multiple physicians of various specialties meet to discuss unusual or difficult types of cancers. Attendance at these conferences continues to be very high and is one of the best
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by
Thomas L. Eisenhauer, M.D., F.A.C.S.
of its kind in western North Carolina. This group allows us to review anonymously certain patients and gather a variety of ideas regarding patient care. These discussions benefit the patients because their care is reviewed by as many as 35 members of the cancer team jointly. The medical staff also benefits because it is an ongoing educational process that allows each specialist to provide input regarding his or her area of expertise, thereby educating the rest of the members. Expansion is word that best describes our program as we move into the future. We are extremely excited about the creation of our new Cancer Center that is expected to open in the fall of 2016. This will allow us to house all of our oncology services, including medical, radiation and surgical oncology, in one facility. New standards were released from the Commission on Cancer for January of 2012. These new standards will set guidelines for the program to enhance the care even more for our oncology patients. Special programs dealing with survivorship plans and genetic counseling are being created. Additional staff are being recruited for the Navigational Program, an area designed to help patients overcome barriers or obstacles to their cancer treatment. Additionally, community evaluations are being performed to identify specific areas of cancer care that need more community education and screening. Pardee’s Comprehensive Cancer Program continues to provide excellent cancer care. New techniques and treatment options are being utilized on a regular basis. Tracking patient outcomes with respect to their specific type of cancer allows us to assess our ability to care for cancer patients. Our statistics show we provide excellent oncologic care for the patients that we treat. This ability is what the people in our area want and deserve so they can receive the care that is best for them, "close to home.”
Cancer Report 2015 Service Line Overview by James Bloodworth Service Line Director
The Pardee Cancer Service Line has made significant progress along several key fronts in 2015: • Completed plans for design of new Pardee Comprehensive Cancer Center • Noteworthy progress toward meeting C of C standards for both Survivorship and Psychosocial Distress • Cancer Research nurses now have a daily presence at Hendersonville Hematology Oncology • Accrued more than 7 percent of active patients for clinical trials; exceeded Commendation requirement • More effective integration of general cancer navigation with medical oncology practice • Provided 11 community cancer screenings; 208 people screened – a 46 percent increase from 2014 • Launched dedicated chemo pharmacy at Hendersonville Hematology Oncology
A Look
Ahead
2016
• Implemented clinical pathway for multidisciplinary Head and Neck program • Increased referrals/provider participation to STAR rehabilitation program by over 50 percent • Hosted first Survivorship Day Retreat at North Carolina Arboretum • Enjoyed a festive, well-attended Celebration of Life evening with breast cancer survivors • Continued to provide monthly educational teleconference in partnership with UNC Lineberger Comprehensive Cancer Center • Collaboration with UNC Lineberger in billing for Hendersonville Hematology Oncology
• Move to new Pardee Comprehensive Cancer Center in September • Provide navigator for survivorship program by late summer • Dedicated nutrition counseling for cancer patients • Improve availability of mental health counseling for cancer patients/caregivers • Increase participation in pharmaceutical clinical trials • Purchase comprehensive diagnostic swallowing and voice tower for Head and Neck program • Launch campaign for low-dose CT lung cancer screening • Implement quarterly survivorship classes and offerings at recommendation of survivors/caregivers • Offer CareGiver curriculum in collaboration with Pardee Signature Care Center • Design and implement volunteer program for new cancer center 4
The New Pardee Comprehensive Cancer Center by James Bloodworth Service Line Director
Pardee's Cancer Service Line team has diligently worked this year to plan for the new Pardee Comprehensive Cancer Center, which will be located in the new Henderson County Health Sciences Building .The new center is slated to open in September 2016. The location of key cancer services in one building will enhance patient convenience, facilitate best practice multidisciplinary treatment by healthcare professionals, and provide optimal access to patient navigation and other treatment and support services. We are grateful to the ambitious effort of the Pardee Hospital Foundation, which has embarked on a capital campaign to raise $6 million for the new building. We applaud all who are donating to this vital cause and all who are raising funds for the effort.
Features planned for the new Pardee Comprehensive Cancer Center: • Location for both Hendersonville Hematology Oncology and Pardee Radiation Oncology • New linear accelerator and CT simulation technology • Cancer navigator offices and a patient/caregiver conference room near the entrance of building • Cancer research nurse, cancer registrar and IRB on site • Four Seasons Palliative Care • Conference and treatment rooms for multidisciplinary treatment, consults and conferences • Dedicated head and neck treatment room • Surgeons located at new building in contiguous space with their own entrance
• 16 chemotherapy chairs, including both private and semi-private option • Chemo pharmacy • Chemotherapy stations and public spaces have view of Healing Garden and are accessible • A comfortable and healing environment with abundant natural light, soothing colors and natural materials • Waiting areas with Wi-Fi and comfortable seating • Covered double lane porte-cochere with patient concierge to assist patients • Onsite café and snack area on second floor of building • Ample dedicated parking
A representative group of our patients and caregivers has participated in the development of plans for the building. It is with great anticipation that we all look forward to September 2016 and the opening of the new Pardee Comprehensive Cancer Center. 5
Right Here. Right Now.
Cancer Report 2015 Cancer Liaison Physician Report by John Hill, M.D.
Hendersonville Hematology & Oncology at Pardee
We are all very excited about the prospect of what the As we have forged ahead in this building project, along next several months will bring to the Comprehensive with the fundraising campaign spearheaded by the Cancer Center at Pardee. After another successful Pardee Hospital Foundation, one thing has become accreditation survey by the American very clear to us all. While we are all excited College of Surgeons Commission on It is not about about the prospect of a shiny new building, Cancer, we move into 2016 looking with all the latest “bells and whistles,” this bricks and mortar, forward to occupying our new, journey has reminded us that it is really glass and steel, paint state of the art cancer center on about people. It is not about bricks and and tile. It is about the mortar, glass and steel, paint and tile. It is the Pardee campus in September. hundreds of patients about the hundreds of patients we serve Historically, we have maintained an we serve in this efficient and effective cancer center in this community every year. It is about despite having our active players community every the young mother who has to fight breast scattered about in several different cancer while raising her children and working year. locations around town. What a joy it will a full-time job. It is about the recently retired be when a consultation with a colleague, a referral grandfather who had to interrupt his “bucket list” in to one our navigators, or an investigation into a clinical retirement to battle lymphoma. It is about providing a trial will only require a few steps down the hallway, as safe, friendly, comforting environment to our patients. opposed to countless phone calls or chains of e-mails.
byW. Mark McCollough, M.D.
2014
This analysis was undertaken to understand our current patterns of multidisciplinary care. A tumor registry review of 2014 breast cancer patients identified 121 cases. The study group was further limited to female patients with ductal carcinoma in situ (18), invasive ductal carcinoma (60) or invasive lobular carcinoma (11) without distant metastases, who underwent definitive surgery and/or radiation at Pardee Hospital. Among the excluded cases were two male patients, four with distant metastases, and two with rare histologies. We saw no cases of inflammatory carcinoma in 2014. The majority of exclusions were due to treatment elsewhere. This left a study group of 89 cases for analysis, to be examined by AJCC stage.
Snapshot of
Breast Cancer Management 6
Stage 0 Stage 0 Cases Twelve of 18
(67 percent) stage 0 patients with DCIS underwent lumpectomy. Seven of the 12 (58 percent) received adjuvant radiation therapy (RT) and eight (67 percent) took adjuvant hormone therapy. Six patients had mastectomy, of which four were bilateral.
Stage I Stage I Cases
Stage II Stage II Cases Sixteen of 28
(57 percent) stage II cases underwent lumpectomy; all received adjuvant radiation. Twelve patients underwent mastectomy, of which eight were bilateral. Four of 12 received postmastectomy RT. Eleven (39 percent) received adjuvant chemotherapy, including the six ER- and three neoadjuvant cases. Fourteen patients took hormone therapy and another four declined.
Thirty-two of 38
(84 percent) stage I cases were managed with lumpectomy, of which 17 (53 percent) received RT. Fourteen stage I lumpectomy patients were ER+ and age 70 years or older: Nine (64 percent) were managed without adjuvant radiation, of which six received adjuvant hormone therapy. Six patients underwent mastectomy, of which two were bilateral. Four of 38 cases (11 percent) received chemotherapy, including both ER- cases. Of 36 ER+ cases, 25 (69 percent) received adjuvant hormone therapy. Three patients declined hormone therapy and it was contraindicated in one.
Eighty-five percent of stage I patients underwent a radiation consultation during their care. Overall, 60 of 74 (81 percent) of stage 0, I and II cases were managed with breast conservation. Of those, 58 percent of stage 0, 53 percent of stage I and 100 percent of stage II cases received adjuvant radiation. Short course (less than four weeks) whole breast schedules were used in five (71 percent) DCIS patients and six (43 percent) stage I cases, approximately half the total cases. Partial breast radiation was not employed in any of the patients. Nearly two-thirds of stage I, ER+, age 70 and older patients were spared radiation after lumpectomy.
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Stage III Stage III Cases Only one of five
(20 percent) stage III cases underwent lumpectomy and radiation. Four patients underwent mastectomy, of which one received post-operative RT. All cases were ER+; one underwent chemotherapy, three received hormone therapy and one refused systemic treatment.
Adjuvant chemotherapy was used judiciously, particularly in early stage patients. Twelve of 38 (32 percent) of stage I patients had documented Oncotype DX testing; none of them received chemotherapy. In conclusion, we had a high rate of breast conservation, with significant percentages of patients spared radiation or given abbreviated courses for patient convenience. Patients benefited from careful selection for adjuvant chemotherapy based on risk, and a high percentage received appropriate hormonal therapy.
Cancer Report 2015 Cancer Incidences & Cases Head And Neck
by site 2014
Total Male Female
Lip 3 0 3 Tongue 4 3 1 Nasopharynx 1 1 0 Gum 1 0 1 Floor Of Mouth 2 2 0 Parotid Gland 2 2 0 Tonsil 3 3 0 Other 1 1 0
Retroperitoneum /Peritoneum
Skin Cancer
Total Male Female 2 1 1
Total Male Female
Melanoma 16 11 5 Non-Melanoma 1 0 1
Digestive Esophagus Stomach Small Intestine Colon Rectosigmoid Junction Rectum Anus/Anal Canal Liver Pancreas Other
Respiratory Larynx Lung Heart/ Mediastinum/ Pleura
Bone
Connective Tissue
Total Male Female
Total Male Female
8 8 0 4 2 2 5 1 4 30 12 18
Breast
1 1 0 12 5 7 2 1 1 4 4 0 14 9 5 1 0 1
Female Genital Total Cervix 3 Corpus Uteri 7 Ovary 7 Vulva 1 Vagina 2
Total Male Female
Male Total Genital
1 1 0 72 36 36 2
1
121 2 119
Prostate 36 Testis 1 Other 1
1
Total Male Female
Urinary
1 0 1
Bladder Kidney Renal Pelvis Other
Total Male Female 7 4 3 8
Total Male Female 24 15 9 12 6 6 4 1 3 1 1 0
Age
Under 20 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90+
1 1 7 23 64 154 163 102 24 | 0
Lymphoma
Blood/Bone Marrow
| 50
31 18 13 Total Male Female 58 28 30
Buncombe Henderson Polk Rutherford Transylvania Other NC Out of State
Meninges
448 27 8 25 14 3
| 150
5 0 5
Orbit, NOS, and overlapping lesion
| 300
| 400
VA - 0.5%
Total Male Female 4 1 3 Total Male Female 1 0 1
Medicare (w/Medicaid) - 4.1%
Payor
Brain
|200
Total Male Female Indian/Public Health - 0.2%
| 150
17
| 0
| 100
Total Male Female
County
Not Insured - 4% Insurance, NOS - 1.9%
Mangaged Care - 16.8%
Medicaid - 3.9%
Medicare
(w/ supplement) - 49%
Medicare - 19.6%
Thyroid Thyroid Other endocrine gland Adrenal gland
Total Male Female 4 0 4 1 1
0 0
1 1
Total number of cancer cases in 2014:
542 9
227male total 315 female
Cancer Report 2015 Cancer Research Report
by James E. Radford, M.D.
First, the numbers. As I write this in November 2015, we have completed our 16th year of involvement in the cancer clinical trials process at Pardee. In the year ending Aug. 31, 2015, 34 cancer patients enrolled in a total of 42 cancer clinical trials. Since the Pardee Cancer Research Program began in 1999, we have had a total of 776 enrollments in National Cancer Institute funded, sponsored, or approved cancer clinical trials. There are currently 44 open cancer clinical trials for 18 different types of cancer at Pardee. These numbers make us a very active member of the nation’s largest cancer clinical research organization, Southeast Clinical Oncology Research, which spans 23 cancer centers in five states (North Carolina, South Carolina, Virginia, Georgia and Tennessee).
leading to the development of cancers that look the same under the microscope, but which are biologically very different. Research published only this week has even demonstrated that different groups of cancer cells within a single patient may have different “driver mutations” that make them cancerous and keep them growing. For the past several decades, our limited understanding of this complexity has dictated a “brute force” approach to cancer treatment, in which we have used similar types of chemotherapy to treat patients with apparently similar types of cancer. This approach, coupled with a robust program of cancer clinical trials, has yielded some remarkable successes: Many previously fatal cancers are now curable (lymphomas, leukemias, testicular cancers), and the “survivability” of many others has improved markedly (breast cancer, prostate cancer, colorectal cancer, lung cancer, multiple myeloma and others). Nevertheless, this approach has been rarely been more than a partial success; not only is chemotherapy (which is basically cellular poison) toxic to the body’s normal tissues (resulting in substantial side effects), but in even the most successfully treated cancers, there are subsets of patients for whom treatment is ineffective.
The year has borne witness to an accelerating trend in cancer research and treatment: The development of treatments based on the specific characteristics of a particular patient’s cancer, an approach identified by the popular nickname, “targeted therapy," or its nearsynonym, “individualized therapy." At its core, “targeted therapy” is the fruit of decades of basic research into the biology of cancer. That it has taken so long for this research to bear fruit is testament to the astonishing complexity of the cancer “problem." We now know of hundreds of different genes, and of thousands of mutations of those genes, that are involved in the development and growth of various types of cancer. Even the cancer of a single individual may contains dozens of mutations that contributed to the changes that resulted in the development of a cancer in what was previously normal tissue. And patients with what we have long considered to be the same type of cancer (for instance, lung cancer) may have different mutations in different sets of genes,
Now we are beginning to understand why. Thanks to decades of basic research into the biology of the hundreds of different types of cancer, we have our first glimpses into the genetic changes that make cancerous cells so dangerous and so hard to kill. Those glimpses have led to a dawning awareness that even apparently identical cancers may harbor different underlying mutations driving their cancerous “personalities," and that these differences can lead to differences in how individual patients respond to treatment. While this vastly complicates cancer treatment (and makes
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prospects for a universal “cancer cure” increasingly remote), the recognition of this complexity, and of its individual components, offers remarkable prospects for improved treatment. And we are now just beginning to realize that potential.
providing a mutation “fingerprint” for any cancer. As new drugs are developed for the resulting treatment targets, clinical trials will be able to test individualized “cocktails” of drugs targeted to the unique fingerprint of an individual’s cancer. It will be complicated (isn’t everything?), but this will signal the beginning of the era of truly individualized cancer treatment, and the end of the era of “one-size-fits-all” treatment.
Enter the era of “targeted therapy,” sometimes referred to as “individualized” or “personalized” cancer treatment. Once we have identified a specific change (such as a mutation) in the biology of a specific cancer, that change can become a “target” for therapy. There are now a huge number of new cancer drugs designed specifically to target these individual aberrations in cancer cells; many have been approved within the past two years for treating a variety of cancers, and many more are on the “fast track” to approval. Some target changes that allow the cancer cell to avoid the immune system, or feed itself, or invade and spread to other tissues, or modify its environment; some target the specific biological pathway that makes a particular cell cancerous in a particular patient. What they have in common is that the choice of therapy depends upon understanding the very specific characteristics of a particular patient’s cancer.
And it’s coming.
We are still early in the era of individualized treatment, but the pace of this change is accelerating. Of the 44 cancer clinical trials currently open through the Pardee Cancer Research Program, 21 determine treatment with a “targeted” agent based upon one or more genetic (or similar) tests of the individual patient’s cancer. The laboratory technology supporting this trend is racing ahead even more quickly: While it used to take weeks and thousands of dollars to identify the presence of a single mutation in a single gene, recently developed technology known as “next-generation sequencing” can scan hundreds of genes simultaneously, in effect
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Cancer Report The Growing Need for 2015 Survivorship Care
by Kristy Capps, RN, CBPN-IC Breast Care Navigator
Leann Noakes, RN, CCRP Cancer Care Navigator
Survivorship is now a hot topic in oncology care. When polling those who have been diagnosed with cancer, there are varied responses as to who a survivor is and when one becomes a survivor. The American Cancer Society defines a cancer survivor as any person who has been diagnosed with cancer, from the time of diagnosis through the balance of life. Due to early detection and improved cancer care, it is estimated that there are more than 14.5 million cancer survivors in the United States today.
Support After Cancer Treatment There are many emotions cancer patients feel over the course of their treatment. Initially, there is quite a bit of anxiety and fear of the unknown. Once patients are comfortable with their care team and begin treatment, their initials fears lessen and they are able to focus on healing. This is largely because they are surrounded by knowledgeable, caring medical professionals while in treatment. Unfortunately, when active treatment is over, patients feel like they are alone and on their own once again. They no longer have that close contact and constant interaction with their healthcare team. Realizing patients feel this way, the Commission on Cancer has challenged accredited facilities to take a closer look at this issue and focus more attention on survivorship.
The Role of Cancer Navigators The cancer navigators are an integral part of the cancer care team at Pardee Hospital. They are there to support, guide and reassure patients from the time of diagnosis through survivorship. The navigators, Cancer Services and Signature Care Center work together to optimize the programs and services available to cancer patients.
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Survivorship Events Two events were held this year to help patients move forward and find their new normal. Paths for Survivorship was held on Aug. 15, 2015 at the North Carolina Arboretum. The day focused on three areas: courage, hope and strength. Activities centered on stress relief and behaviors that decrease anxiety and increase self-efficacy. Cancer survivors and their caregivers were also given the opportunity to participate in yoga, art and music therapy sessions along with a wide variety of other therapeutic opportunities. The event was such a success that we will be offering quarterly events that focus on survivorship. The first quarterly event was incorporated into the 6th Annual Celebration of Life for breast cancer survivors that was held on Oct. 22, 2015. In addition to the traditional inspirational stories from local and national breast cancer survivors, we offered an art therapy session for all who attended. Our new “artists� enjoyed the evening and appreciated the opportunity to try something new. The watercolor paintings from this event were displayed at the Signature Care Center during the month of November. The community was asked to vote for their favorite painting and the top four winners will be displayed proudly in Pardee’s new cancer center. We are very pleased with the results from the programs that were offered this year. We are committed to continuing our efforts and making sure cancer survivors at Pardee Hospital are able to make the most of every day and find courage, hope and strength.
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Cancer Report 2015 Elizabeth Reilly by Charles A. Albers, M.D, F.A.C.S.
Medical Director, Elizabeth Reilly Breast Center
Breast Cancer Update
Life was much simpler when I was first learning to treat breast cancer 40 years ago. A woman or her physician would discover a breast lump. The lump was removed and if it was found to be malignant, she would undergo a radical mastectomy. She then faced the possibility of metastatic disease. If that occurred, she underwent removal of her pituitary gland or adrenal glands. If her cancer progressed, she was placed on chemotherapy until she was terminal.
At the Elizabeth Reilly Breast Center, we take a multidisciplinary approach to the treatment of breast cancer. All patients are presented at our weekly cancer conference where not only physicians, but nurses, therapists, research coordinators and others weigh in on the best treatment for each patient. The steps are coordinated by Kristy Capps, RN, BSN, CN-BN, our breast care navigator, to assure that no one “falls through the cracks." Our care has been accredited by the NAPBC and other organizations that survey and accredit programs across the nation.
That was state of the art then. There were no screening mammograms, lumpectomy with radiotherapy, needle biopsy, adjuvant chemotherapy, hormone-blocking drugs like Tamoxifen or Arimidex, sentinel node biopsy, OncoType, partial breast irradiation, targeted drugs like Herceptin or Perjeta, bone marrow boosting drugs, BRCA testing, and the list goes on.
New things are coming down the pike. In December, our new tomosynthesis mammography unit should be arriving. This imaging device takes multiple “slices” of the breast to help us better see detail without overlying densities obscuring an area. This machine provides superior imaging and will not expose the patient to more radiation than a traditional mammogram. The new Pardee Comprehensive Cancer Center will house a state of the art radiotherapy unit. New drugs are being developed every day. However, none of these advances replaces the individualized, compassionate care by a team that treats every patient as they would a doctor’s wife.
The point of this is to illustrate the tremendous strides that have been made in the diagnosis and treatment of breast cancer during this surgeon’s career. New strides are being made as we attempt to better understand this complicated disease and tailor our treatment to the individual patient. It is no longer one-size-fits-all, nor should it be.
New strides are being made as we attempt to better understand this complicated disease and tailor our treatment to the individual patient. 14
Pardee Cancer Registry
by Carol P. Brown, ABA, CTR Cancer Program Coordinator
When someone hears "cancer registrar," he or she may think of someone who registers patients at a hospital or physician's office. However, I describe my job as a cancer registrar as similar to a detective looking for details to solve a case.
What is a cancer registry? The information we collect
How the cancer registry benefits our community
Why the cancer registry is necessary
The purpose of a cancer registry is to collect detailed information about people who are diagnosed with and/or treated for cancer in a hospital or physician's office. Collecting information about cancer cases, as well as many other diseases, is required by North Carolina law. It is also the law in many other states and foreign countries. In the registry, I collect a great deal of information on each patient. I start with demographic information, including: • Place of birth • Race • Occupation • Family history • Tobacco use • Alcohol use
This information helps us to determine which cancers we treat may be related to tobacco and alcohol use, family history and/ or occupational exposures. I also collect information about an individual's cancer diagnosis, including: • The exact site or organ in the body in which the cancer is located • The type of cancer • The stage of disease • All of the treatments the patient received
Once this data is available, it is recorded in a software program that allows us to run reports on our specific patient population to help us determine which screening and prevention programs we need to offer to our community. This data also helps us to determine which age groups, races and ethnicities are affected most. We can also look at which patients present with late-stage disease to see if we need to offer screening programs or educational sessions to help improve early detection. I am often asked why my job is necessary and why the information I collect is so important. When you read about cancer statistics in newspapers, magazines or medical journals, much of the information contained in those publications came from cancer registries across the country. That is why it is so important for cancer registrars to collect accurate, complete information. It is our hope that, although we do not care directly for patients, the information we collect helps with cancer research so one day there may not be a need for cancer registries. 15
Cancer Services Breast Center..............................................................................828.698.7334 Cancer Center.............................................................................828.696.1341 Cancer Research.........................................................................828.696.4716 Cancer Navigators Breast Cancer.........................................................................828.698.7334 General Cancer......................................................................828.698.7317 Hendersonville Hematology and Oncology at Pardee.............828.692.8045 Mammography Services.............................................................828.696.1305 Radiation Oncology...................................................................828.696.1330
800 North Justice Street Hendersonville, NC 28791 9020-275 (2/24/16)
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