May 2024 Newsletter

Episode 26: A Conversation with Mary Maul, Education Manager, NCRA

In this segment of Cancer Registry World, we welcome Mary Maul, Education Manager for the National Cancer Registrars Association. The discussion focuses on the vast array of educational offerings sponsored by NCRA, the future of in-person meetings in the era of virtual educational opportunities and methodology to assess the quality of educational programming. Please enjoy listening and learning!

Clinical Corner - May 2024

Proton Therapy and the Cancer Registry

Soon, we will be opening a Proton Therapy Treatment Center at my cancer institute. Rather than using a conventional photon beam, the proton treatment has gained favor in its ability to be extremely focused on a specific tumor, while protecting surrounding non-cancerous tissue from radiation injury. Since the first operational proton center opened in 1990, this therapy has transformed from a little-known niche technology to become widespread and well-known to both providers and patients.

When considering appropriate indications for proton therapy, the end goal needs to be prespecified, either dose-escalation beyond that which can reasonably be achieved with photons or toxicity minimization. Classic indications include dose escalation for radio-resistant tumors such as chordoma and chondrosarcoma, with improved tumor control or facilitation of a more comprehensive therapy that may otherwise be too toxic, such as craniospinal irradiation (CSI). Alternatively, late toxicity mitigation for pediatric patients may lead to less risk of secondary malignancies, or a reduction in heart dose for patients with breast cancer may reduce the rate of treatment-related cardiac events and subsequent associated costs of care.

Another intriguing value-based consideration is acute toxicity mitigation, which may be particularly relevant for elderly or frail patients who are less able to tolerate definitive combined modality therapy or may not even be offered curative intent therapy at all. Reducing acute toxicity may reduce treatment breaks, hospital admissions, and consequent medical procedures that outweigh the up-front cost of therapy for vulnerable patients. In addition, patient quality of life and treatment preference are major considerations, and patients should be included in the investigatory process to capture what is most important to them as they weigh their treatment decisions.

Awareness of these indications, considerations, and the complete cost of care will ultimately answer the value-based proposition and better define the role of proton therapy in the field of oncology. Finally, just as conventional radiation treatment has been captured in our cancer registries, the specific characteristics of proton therapy must be included in our patient abstracts, thus allowing for adequate evaluation of outcomes using this exciting, new technology.

April 2024 Newsletter

Clinical Corner - April 2024

The coding of specific operative approaches to cancer is extremely important in assessing outcomes after diverse operative approaches for the same cancer site. This is certainly true for the management of colon cancer.

Although both robotic and laparoscopic surgical approaches are considered minimally invasive and use small incisions and a camera to view the procedure, surgeons performing laparoscopy manually manipulate the tools and use a thin telescopic rod outfitted with a tiny two-dimensional laparoscope to view the surgical site, whereas surgeons performing robotic surgery have a control console to maneuver the robotic arms outfitted with surgical tools. The more advanced technology of robotic surgery not only may create a higher-quality three-dimensional view of the procedure but may also offer better precision and range of motion and eliminate any hand tremors by the surgeon.

In a recent retrospective study, investigators compared the outcomes achieved by robotic and laparoscopic procedures. Colorectal procedures were identified by location: right and left colectomies and low anterior resections. They found that 71% of the robotic procedures for right colectomies resulted in excellent outcomes compared with 64% of the laparoscopic treatments. The results were similar for left colectomies at 75% vs 68%, respectively. Further, the investigators discovered that the patients who had robotic surgery may have had shorter hospital stays, lower rates of complications, more lymph nodes harvested, more accurate cancer staging, fewer conversions to open surgery necessitated by anatomic challenges, and better return of bowel function. Only the patients receiving low anterior resection experienced better outcomes with laparoscopic surgery.

As newer operative approaches are introduced in the future, the capture of these operative approaches is mandatory for our registry abstracts.

CRStar Celebrates NCRW 2024

The CRStar team joins cancer registrars throughout the world to observe the 28th annual National Cancer Registrars Week (NCRW), April 8-12, 2024. It is our privilege to take a moment to honor and recognize the invaluable contributions of our dedicated cancer registrars.

This week is not only a time to acknowledge the critical role of cancer registrars in our healthcare system but also an opportunity to express our gratitude for their dedication, professionalism, and compassion. Behind every statistic, every treatment plan, and every research breakthrough, there are individuals diligently recording and analyzing data to make a difference in the lives of cancer patients and their families.

We extend our heartfelt appreciation for your unwavering commitment to excellence. Your work is instrumental in shaping the future of cancer care, and we are profoundly grateful for your contributions.

Thank you for your continued dedication and for being an essential part of our healthcare community.

We hope to see you at NCRA 2024 in Indianapolis from April 24-27! You can find us at Booth #201 in you are attending in person or see our virtual booth if you are attending online.

CRStar by Health Catalyst is a Silver Sponsor for the 2024 NCRA Educational Convention in Indianapolis, IN

CRStar by Health Catalyst is participating in the 2024 NCRA Education Convention in Indianapolis as a Silver Sponsor. Our team is excited to be on-site to share how CRStar can provide cancer programs with a valuable foundation of data and insights that provide for the best cancer care for every patient.

Connect with us at Booth 201 ... Stop by to see some familiar faces, meet our new team members and register for our door prize!

Episode 25: A Conversation with Linda Corrigan, Manager, Cancer Registry & Accreditation at Baltimore Washington Medical Center and Adam Ebbin, Public Policy and Strategy Consultant with NCRA

This edition of Cancer Registry World features guests Linda Corrigan, MHE, RHIT, ODS-C, Manager of Cancer Registry & Accreditation at Baltimore Washington Medical Center and Adam Ebbin, Public Policy and Strategy Consultant with NCRA. Join them as they delve into the arena of legislation and advocacy as these topics relate to important issues for cancer registries and Oncology Data Specialists. The Counting Veterans Cancer Act, discussed in this segment, was signed into law on March 9, 2024. Please enjoy listening and learning!

March 2024 Newsletter

Clinical Corner - March 2024

The National Cancer Institute (NCI) recently released a publicly available calculator for people newly diagnosed with oral cancer. This represents the first cancer survival calculator that provides personalized estimates of the likelihood of surviving or dying from oral cancer or other causes. An analysis evaluating the new calculator revealed that people with oral cancer are more likely to die from other causes compared with their peers without oral cancer, and that noncancer survival worsens with cancer stage.

With its unique design, the calculator represents perhaps one of the most sophisticated and comprehensive tools to date by integrating multiple population-level data sources to account for general health status and disease exposures such as alcohol and tobacco, socioeconomic status, and coexisting conditions. When assessing survival, factors such as cancer stage and tumor size are key, but comorbidities also play a crucial role. For oral cancer, where alcohol and tobacco use are notorious risk factors, comorbidities occur frequently and are often serious.

To create a model that provides more "holistic and personalized" estimates and includes a host of factors that can impact the risk of death, the creators of the calculator tapped into data from the Surveillance, Epidemiology, and End Results (SEER) database to develop the SEER Oral Cancer Survival Calculator (SEER OCSC). This is yet another example of the use of accurate cancer registry data. More of these calculators and nomograms will be developed in the future for a multitude of cancer sites.