USA Today Supplement

USA Today showcases the latest  advancements in cancer treatment and what it means to survive through cancer treatment and beyond. This supplement includes articles covering:

Personalized medicine in the treatment of cancer; changing life habits to help prevent cancer;  patients need access to information about Clinical trials; what it means to be a cancer survivor and the latest advances in the treatment of cancer

http://www.canceradvocacy.org/assets/documents/usa-today-beating-cancer.pdf

Mammograms

Here is an article from The American College of Radiology that outlines practice guidelines for both screening and diagnostic mammography. The article outlines specification of the various types of mammography, assessment BI-RADS descriptions, and timeliness in reporting results to the patient. The article can be found at:
http://www.acr.org/SecondaryMainMenuCategories/quality_safety/guidelines/breast/Screening_Diagnostic.aspx

Study Finds Percentage of Breast Cancer Patients Not Taking Medication

From the website:
"A new study of nearly 8,800 women with early-stage breast cancer found that fewer than half  approximately 49 percent  completed their full regimen of hormone therapy according to the prescribed schedule. Investigators found that younger women were particularly likely to discontinue treatment. The findings underscore the need to both better understand the reasons behind such treatment non-compliance and also develop interventions to reduce it."
http://www.biosciencetechnology.com/News/Feeds/2010/06/products-chemicals-and-reagents-fewer-than-half-of-breast-cancer-patients-adhere-t/

Colorectal Cancer Coalition

This organization is dedicated to winning the fight against colorectal cancer. They produce a newsletter called C3:Momentum which is full of valuable information,  including free online webinars. The website is a wealth of information including advocacy and patient resources. They can be found at:
http://www.fightcolorectalcancer.org/  and on Facebook.com/colorectalcancer.

CANCER SURVIVORSHIP WEB PRESENTATION

Brown Bag Chat: Cancer Survivorship:
Online replay of an internet based discussion on Survivorship:
http://www.oncolink.org/blogs/index.php/2010/06/cancer-survivorship/

Reading on the web

CANCER MEDICINE
This edition of the text was printed in 2000, and will probably not be a good resource for current treatment modalities, but otherwise offers a great reference to general cancer information. The table of contents allows the reader to "click on" a link that connects to a particular chapter in the book.
New editions of this manual are available for those wishing to read more current material.

From the website:
"Cancer Medicine is the best known and respected work in the field of oncology and was the first comprehensive textbook devoted to reporting and assessing the rapid and continuous development in the diagnosis and treatment of cancer. Cancer Medicine is widely recognized as a leading reference resource for medical oncologists, radiation oncologists, internists, surgical oncologists, and others who treat cancer patients. Cancer Medicine e.5 continues this high standard while providing updated information in all areas of oncology - including molecular biology, pathology, imaging interventional radiology, endoscopy, surgical oncology, radiation oncology, and medical oncology."

http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cmed

Melanoma

Now that it is summer, there are plenty of magazine articles on skin cancer awareness. One I recently read shows, not only what melanoma looks like, but the different types involved and where they are most likely to occur. So, I thought I'd share that information here:
Superficial spreading melanoma is the most common of all types 70% and occurs most often on the upper back in men and back and legs in women. These are flat or slightly raised, irregular borders, and varigated in color. Changes in a mole is sometimes noted.
Nodular melanoma  is typically found on the trunk and legs. These appear as raised a dark brown or black bump, but may also be red, blue, gray, tan or skin toned. Ulceration or bleeding is common. this lesion has rapid growth over weeks or months. Nodular melanoma makes up 10-15% of cases.
Lentigo Melanoma occurs in sun exposed areas, head, neck and arms. These appear as tan to brown/black patches. Irregular borders mimic large asymmetrical sun spot. These lesions are slow growing. 15% of new cases diagnosed.
Acral Lentiginous Melanoma make up 29 to 79% of cases in blacks, asians, and hispanics; 2 to 8% in caucasians. These lesions appear on the soles of feet, palms of hands and under fingernails and toenails. Appears as irregular brown/black pigmentation on skin or under nails. Ulceration in this lesion is common.


Source: Redbook magazine (http://www.redbookmag.com/)

Patient Resources

This website is an excellent place to start if you're looking for information about cancer or cancer treatments. This organization produces an outstanding resource in their publication "Cancer Guide" and they now have individualized cancer guides that are site specific.  If you aren't familiar with these materials, you owe it to yourself to check out this site and order some of these free materials.

http://www.patientresource.net/Home.aspx

Facebook offers Networking and Cancer Registrar training

Facebook is a great way to network with others and you can find Cancer Registars on Facebook.

http://www.facebook.com/group.php?gid=49137561355#!/group.php?gid=49137561355&v=info

Michele Webb is offering  Cancer Registry training and has announced a free teleseminar covering the subject. For those interested in becoming a registrar or those who will be taking their entrance exams--this looks like a great opportunity to learn more. Below is the information:

Michele Webb "It's official and I'm getting really excited! On Tues, June 22nd @ 6 pm PST I'll be hosting my first free 60 min teleseminar on "How to Become a Cancer Registrar." Anyone that wants to attend can register at http://CancerRegistryTraining.com/register.html. This is going to be fun!"

The Importance of A Multidisciplinary Team

Today I was privilaged to see how a multidisciplinary team works together in decision making. I followed a close family member as he navigated the first office visits for suspected cancer. The team of specialists ranged from pulmonary medicine, thoracic surgery, radiation oncology and medical oncology.

The pulmonary medicine specialist was most concerned with a pulmonary co-morbidity and how this would play a major part in the health of the patient over the next twenty four months. He was not as concerned about the suspicious lung nodule that was an incidental finding on X-ray, feeling strongly that it was not as pressing as the immediate condition of worsening COPD.
Recommendation, wait a month and repeat CT scan. Antibiotic to combat residual pneumonia in the lungs.

The thoracic surgeon's opinion mirrored pulmonary medicine, with the addition of stressing that the test results were still inconclusive as to the diagnosis of the nodule. Recommendation was to wait for a month, repeat CT scan and look to see if the nodule had changed in size. General opinion would lead to the belief that this nodule probably was not cancer and even if it was, would be slow growing due to a PET scan that indicated limited uptake of contrast. Uptake by the lymph nodes was thought to be due to infection and/or inflammation.

Radiation Oncology was VERY different, with recommendation that a lymph node biopsy be conducted. Discussion centered on some uptake at the subcarinal and hilar lymph nodes. Biopsy of these nodes would not compromise the patient and could be done for definitive diagnosis. Assessment by this professional leaned more towards a cancer diagnosis and evaluation for staging the patient so that a treatment plan could be formulated. Extensive discussion focused on treatment options for various stages should the biopsy be negative or reveal cancer spread to lymph nodes.

The radiation oncologist explained that this case would be included in a tumor board discussion that would include all physicians involved with the case, as well as others with similiar knowledge and experience. After presentation of this case, the radiation oncologist would share the tumor board concensus with the patient.

From this experience, I got to witness the various thought processes, analysis and conclusions that each physician went through in an individualized setting. It was surprising to see the varying degree of importance and urgency each placed on the possiblity of a cancer diagnosis. It was also very encouraging to hear that each one will come to the table and as a team work together to provide the very best possible care in a difficult and challenging situation.

Looking at Quality Improvement on the Web

Below is an informative website focusing on tools that can be used to improve quality in health care:
"IHI.org is an Internet system that provides resources, at low or no cost, to people all over the world to help them take effective action to improve health care. It will be helpful to people in many different roles in the health care system — including (but not limited to) physicians, nurses, other clinicians, managers, executives, policy-makers, educators, and interested members of the lay public.
IHI’s policy is to make the content posted on IHI.org free and open to all, as often as possible. Our goal is for thousands of users around the world to access our resources in order to promote the improvement of health care quickly and broadly."
http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/HowToImprove/

A highlight of the PDCA Cycle used in getting from a 'problem faced' to 'problem solved'.
http://www.hci.com.au/hcisite3/toolkit/pdcacycl.htm#Plan-Do-Check-Act

American Cancer Society Survivors Network

A website for survivors from The American Cancer Society:
http://csn.cancer.org/csnhome

NAACCR Everything for 2010

NAACCR is pleased to announce “Everything 2010” a “one-stop-shop” for 2010 change implementation. We have gathered important information, programs, documentation and updates concerning 2010 and placed them in one convenient location for you.

http://www.naaccr.org/index.asp?Col_SectionKey=28&Col_ContentID=544

SEER Abstracting Forms for 2010 cases

SEER Abstract Addendum Generator for 2010 Cases Abstracted under Collaborative Stage version 1 (CSv1)

Based on the site and histology entered by the user, the correct schema will be chosen and a document opened in Microsoft Word with a listing of new fields and CS fields including the names of all of the CS site-specific factors for this schema.

http://seer.cancer.gov/tools/absgenerator/

The Latest In Melanoma Research

New England Journal of Medicine:

Improved Survival with Ipilimumab in Patients with Metastatic Melanoma

http://content.nejm.org/cgi/content/full/NEJMoa1003466

http://www.msnbc.msn.com/id/37514210/ns/health-cancer/

Study: Radiation boosts prostate cancer survival

http://www.dailyfinance.com/article/study-radiation-boosts-prostate-cancer/1101012

CHICAGO -Doctors are reporting a key advance in treating men with cancer that has started to spread beyond the prostate: survival is significantly better if radiation is added to standard hormone treatments.

Patient Treatment Guides

My Cancer Advisor is a great resource for patients and professionals alike. This organization prints a Cancer Guide that is a valuable tool for patient understanding, but would also be an excellent reference to the beginning registrar. It contains articles covering the various forms of cancer, along with diagrams and staging information. These are updated frequently and can be ordered free from http://www.patientresource.net/

Recently I found that they are offering a patient treatment guide for Breast, Colon and Ovarian that breaks the diseases out by stage and addresses appropriate treatment for that particular stage, siting NCCN guidelines in the references. Below are the links to these files:
http://www.patientresource.net/Treatment_Charts.aspx

New NCDB Submission Changes

NCDB has changed their submission process. Consult the latest version of the CoC Flash for details.
Below is a link to the new submission schedule:

http://www.facs.org/cancer/ncdb/callfordataschedule.pdf

CoC Website showcases 2010 Changes

From the CoC Flash:
"A new comprehensive CoC web site,
http://www.facs.org/cancer/ncdb/2010atyourfingertips.html is now available to give staff in CoC-accredited programs easy access to resources for data and standards changes implemented in 2010. The content includes links to manuals and educational materials for new and changed codes and coding instructions, recommendations for implementing the 2010 data changes, links to software resources for converting and editing registry data, and links to information about the 2010 changes in CoC standards and surveys."

CSv2 Site and Instructions: http://www.cancerstaging.org/cstage/manuals/index.html

SEER tool for abstracting 2010 cases prior to software upgrade:
http://seer.cancer.gov/tools/absgenerator/

Where in the world is...

This is the most interesting site. It's called Google Earth and when downloaded to your computer you simply type in any address or business and a satellite map is displayed. You can also click on a geographical site and a window will display that tells you how to map from the current location to another location.

Website Description: Google Earth lets you fly anywhere on Earth to view satellite imagery, maps, terrain from galaxies in outer space to the canyons of the ocean. You can explore rich geographical content, save your toured places, and share with others.

http://earth.google.com/intl/en/download-earth.html

A tour of what this website and download can do:

http://earth.google.com/tour.html

2010 reference sheet to the CS SSF Schema

From the Florida Cancer Data Services website is a reference sheet to the CS SSF Schema:
http://fcds.med.miami.edu/downloads/dam2010/CS_SSF_by_Schema.pdf