CRANE Newsletter
Volume V Issue 1 www.crane.crane.org January 2005
MESSAGE FROM THE PRESIDENT
First of all, I would like to thank Paula Darsney for the fantastic job she did in planning and conducting the annual meeting in Plymouth. Despite the battle with technology, the program content was excellent. Thank you, Paula, for a job well done!
There are three goals I would like to accomplish this year. The first goal is to provide educational opportunities for all CRANE members. With a regional organization like CRANE, a workshop held in Southeastern Massachusetts is difficult for members in Vermont or Maine to attend. For that reason, we will be conducting four workshops in the coming year. The first will be held at Portsmouth Regional Hospital on March 11, 2005. This meeting will serve our members in New Hampshire, Maine and parts of Massachusetts. We have been in discussion with a facility in the Boston area and will locate sites for members in Southeastern Massachusetts and Rhode Island as well as a site for members in western Massachusetts and Vermont. This is an aggressive agenda, but given the distances involved, I feel it is worthwhile.
The 2005 Annual Meeting, which will be held in Marlborough, Massachusetts, will be easily accessible from all of New England.
The second goal is to solidify CRANE as a regional organization. Providing equal educational opportunities is one step. A second step involves creating liaisons to every New England state registry. While this action may seem symbolic, I see it as a clear statement that CRANE is committed to providing equal opportunity for all members.
The last goal is much more difficult because it involves getting the membership to become involved in CRANE. It is my impression that in the past the organization was made up of some members who were active in CRANE for only a short time. As a result, a small group of people tends to serve for extended periods, while many members are simply users of services. This is not an indictment, but an observation. My aim is to get more people involved and become members; not just users of services. In the coming year I intend to increase communication between the Executive Committee and the membership. If members are well informed of CRANE activities, they might be more inclined to sit on a committee or run for office.
In this Issue
From the President
1
From the Immediate Past President
2
From the Vice President
3
Upcoming Events
3
From the President Elect
4
CRANE Officers, Committee Chairs & Committee Members
4
From the CRANE Editorial Team
6
Nominating Committee Report
6
From the Treasurer
7
Membership Report
8
Immunity Therapy for Metastatic Breast cancer
9
Job Bank
10
New CTRs
11
ACoS Update
11
FORDS Update
12
Cancer Surprise
12
Cervical Cancer Vaccine Works Well
13
Young Women’s Surgical Cancer Risk Very Low
15
Web Sites of Interest
16
David Rousseau, BS
President, CRANE
Message from the immediate past president
The Plymouth Radisson was the site of the 29th Annual Meeting for CRANE. The hotel was nicely located and was a very comfortable place for a meeting. The food was delicious. The attendance was over 100 both days, with Monday having the highest attendance. The speakers were wonderful.
Paula Darsney did an outstanding job arranging the meeting with help from her committee: David Rousseau, Anita Davies, and Susan Trout. I felt it was a wonderful meeting. Thanks to all of our wonderful vendors for their exhibits and financial support, which helps keep the annual meeting costs down.
Dr. John Garrison from Lahey Clinic began the meeting with a very informative talk on stress. The only glitch in all of the presentations was audiovisual difficulties. This was a source of stress for the speakers, including Dr. Garrison. Still, according to one comment from the evaluation, “Dr. Garrison was very enjoyable and a nice way to get things started.” The last presentation was a ‘Jeopardy’- like game on FORDS. It was surprisingly well attended for an end-of-meeting presentation.
Other presentations included Update on Liver and Kidney Cancer, Central Registry Updates, Non Hodgkin Lymphoma, Multiple Myeloma, the 2004 Commission on Cancer Standards, MammoSite Radiation Therapy in Early Stage Breast Cancer, plus the results of the NCRA survey on the workplace. April Fritz was wonderful with her Review of 30 Years of Registry and Central Nervous System lecture. We all learned a lot.
I think the meeting was well attended by all of the states. We appreciate everyone’s willingness to attend the business meeting. We feted Joan Korslund from Metro West Medical Center in Massachusetts, who won CRANE’s Most Distinguished Member for 2004. We presented her with a plaque. Ann Gray from Fletcher Allen Health Care in Vermont won the Data Usage Contest. Ann will be given a certificate for free registration for the 2005 Annual Meeting. Congratulations to Joan and Ann!
I regret that a list of new CTRs was not yet available at the time of the Annual Meeting, but your names are in this newsletter. Congratulations to all of you!
Paula Darsney is still in the process of tallying the evaluations from the Annual Meeting. However, here are some of the comments she has tallied so far:
• “Dr. Garrison was very enjoyable; nice way to get things started.”
• “Dr. Banner was excellent.”
• “Frank Ascoli was a great speaker; very interesting and useful.”
• “April Fritz: Clone this speaker!”
• “The usefulness of the topics this year was greatly appreciated.”
• “Jean Treacy did a great job of getting us back on time!”
• “Dr. Jacobson’s presentation was very useful and very pertinent to registry management.”
• “Cynthia Boudreaux’s topic was the most useful on the program.”
• “Central Registry Updates: Suggest breakout sessions.”
• “Survey: Depressing but accurate information. I wish we could find a solution.”
• “Jeopardy was a fun way to learn.”
Another year has come and gone. President David Rousseau and the Executive Board have taken the reins of CRANE. I wish them all well.
I hope all of you had a wonderful holiday season. Happy New Year!
Jane Nalwalk, BA, CTR
Past President, CRANE
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M
ESSAGE FROM THE VICE PRESIDENT
Happy and prosperous New Year to everyone!
I would like to thank you for providing me with the opportunity to serve CRANE as Vice President for the coming year. Those who know me are aware that I take my commitments seriously, and I will try my hardest to ensure I that I do not disappoint you.
I am thrilled that one of my responsibilities is the annual meeting. I truly believe annual meetings are extremely important not only for the educational opportunities they bring, but also for the networking opportunities they offer, especially to new members. It was at a TRANE Annual Meeting in 1986 that I first felt part of a group that was warm, friendly, and that welcomed a “rookie” cancer registrar with open arms. As a medical records student and as an Accredited Records Technician I had attended other meetings before, but had never felt part of a community of people that could make new members feel as welcome as Cancer Registrars do.
CRANE’s 30th Annual Meeting will be held in Marlborough, Massachusetts. It will be hard to top this past meeting at the Radisson Hotel Plymouth Harbor in Plymouth, Massachusetts. Paula Darsney and the Annual Meeting Planning Committee worked hard to ensure we had a memorable meeting. I know you all agree with me that they did a terrific job.
Your Executive Board will do its best to ensure Crane’s 30th Annual Meeting is a fun & educational meeting, but in order to accomplish this we will need volunteers to help with running the meeting. If you have ever thought about helping CRANE grow, but have never had the time to commit yourself to an Executive Board post or to be a member of a committee, this is your opportunity to serve CRANE while at the same time have fun. I urge you to volunteer with putting packages together, introducing speakers, manning the registration table, helping with the distribution of speakers′ notes, helping with the audiovisual equipment, and all the other things that help organize a successful meeting. And, if you see a face you do not recognize or see someone you have never met before, I urge you to make this organization stronger and friendlier by introducing yourself and making this person feel welcome.
Please e-mail me at hvalcarcel@emh.org with your ideas or comments to ensure we have a memorable 30th Annual Meeting.
Hope Valcarcel, RHIT, CTR
Vice President, CRANE
UPCOMING EVENTS
When What
March 11, 2005 CRANE Educational Conference at Portsmouth Hospital in Portsmouth, New Hampshire. This is in the planning stages, but should provide 5 ½ CEUs. Information will be released soon.
April 10-13, 2005 NCRA 31st Educational Conference, New Orleans, LA. Register at: registration@ncra-usa.org
June 7-9, 2005 NAACCR 2005 Annual Meeting will be held at the Hyatt Regency Cambridge in Cambridge Massachusetts. You can find more information from NAACCR by going to: http://www.naaccr.org/index.asp?Col_SectionKey=9&Col_ContentID=228
June, 2005 CRANE Educational Conference at Metro West Medical Center in Framingham, Massachusetts. Information will be posted in our April Newsletter.
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MESSAGE FROM THE PRESIDENT-ELECT
Thank you, fellow members of CRANE, for electing me to the position of President Elect. I look forward to serving you, and I know that the next few years will be fun and informative. As David and Hope make plans for the 2005 Annual Meeting, I am already setting up interviews with facilities for the 2006 meeting. The 2006 meeting will take place in a Northern State: Maine, Vermont, or New Hampshire.
I am looking forward to working for you. Please feel free to contact me with any suggestions.
Respectfully,
Ruth Maranda, LPN, CTR
President Elect, CRANE
CRANE OFFICERS: EXECUTIVE BOARD – 2005
President
David Rousseau, BS
Massachusetts Cancer Registry
Massachusetts Department of Public Health 250 Washington Street, 6th Floor
Boston, MA 02108-4619
Phone: (617) 624-5656
E-mail: david.rousseau@state.ma.us
President-Elect
Ruth A. Maranda, LPN, CTR
Massachusetts Cancer Registry
Massachusetts Department of Public Health 250 Washington Street, 6th Floor
Boston, MA 02108-4619
Phone: (617) 624-5651
E-mail: ruth.maranda@state.ma.us
Vice President/Annual Meeting
Hope Valcarcel, BS, RHIT, CTR
Eastern Maine Medical Center
489 State Street
Bangor, ME 04401
Phone: (207) 973-5828
E-mail: hvalcarcel@emh.org
Past President
Jane S. Nalwalk, BA, CTR
Lahey Clinic Medical Center
41 Mall Road
Burlington, MA 01805
Phone: (781) 744-2527
Fax: (781)744-5491
E-mail: jane.s.nalwalk@lahey.org
Treasurer
Joan Burgomaster, RHIA, CTR
Lahey Clinic Medical Center
41 Mall Road
Burlington, MA 01805
(781) 744-3056
E-mail: joan.burgomaster@lahey.org
Secretary
Barbara A. Snyder, CTR
Portsmouth Regional Hospital
333 Borthwick Avenue
Portsmouth, NH 03801
Phone: (603) 433-5290
E-mail: barbara.snyder@hcahealthcare,com
CRANE COMMITTEE CHAIRS – 2005
Bylaws
Susan V. O’Hara, CTR
UMASS Memorial Medical Center
55 Lake Avenue North, RM HB-382
Worcester, MA 01655
Phone: (508) 856-5585
E-mail: oharas@ummhc.org
Education
Nancy L. Hinchliffe, RHIA, CTR
26 Longmeadow Road
South Weymouth, MA 02190
Phone: (781) 335-3359
E-Mail: nancy_ctr@msn.com
Membership
Deborah L. Perriello, BA, CTR
IMPAC Medical Services
11 Frothingham Road
Burlington, MA 01803
Phone: (781) 272-0059
E-Mail: dperriello@impac.com
Public Relations/Publications
Paula D. Darsney, BS, CTR
North Shore Cancer Center/Salem Hospital NSMC Cancer Center
17 Centennial Drive
Peabody, MA 01923
Phone: (978) 573-5336
E-mail: pddarsney@aol.com
Nominating
Joan Korslund, CTR
Metro West Medical Center
Finance
Joan Burgomaster, RHIA, CTR
Lahey Clinic Medical Center
4
115 Lincoln Street
Framingham, MA 01701
Joan.korslund@tenethealth.com
41 Mall Road
Burlington, MA 01805
Phone: (781) 744-3056
E-mail: joan.burgomaster@lahey.org
CRANE COMMITTEE MEMBERS – 2005
Bylaws
Judith April, CTR
Cathy Gray
Mary Tweed, CTR
Education
Jean Aclin, MPH, RHIA, CTR
Pat Lee, CTR
Membership
Heidi Allen, CTR
Judy Mutchler
Rina Stamas
Public Relations/Publications
(Newsletter Editors)
Pam Hinkle, CTR
Hope Valcarcel, BS, RHIT
Nominating
Katrine Batcho, CTR
Nancylee Campbell, CTR
Joan M. Korslund, CTR
Judy Raymond, CTR
Judy Spealman, CTR
Finance
Ruth A. Maranda, LPN, CTR
David Rousseau, BS
Anne T. Shaw, CPA
CRANE EDITORIAL COMMITTEE MEMBERS – 2005
Jane S. Nalwalk, BA, CTR (Immediate Past President)
Gail Reynolds, MS, RHIA, CTR (Member at Large)
Ruth A. Maranda, LPN, CTR (President-Elect)
CRANE ADVISORS – 2005
Shirley Foret, CTR
Paula Darsney, BS, CTR
Dianne V. Hultstrom, BS, RHIT, CTR
Anne Shaw, CPA
CRANE LIAISONS – 2005
Susan T. Gershman, MPH, Ph.D., CTR (MCR)
Dianne Hultstrom, BS, RHIT, CTR (ACoS & CRANE web site)
Veronica S. Mead, M.Ed., CTR (ACS)
Shirley Foret, CTR (NCRA)
5
MESSAGE FROM THE CRANE EDITORIAL TEAM
Happy New Year to everyone!
We would like to thank all the members who have taken the time during the year to give us feedback both on the quality of the CRANE newsletter and of our efforts as editors. This has been a year of learning for us. We learned as we went along thanks to the great instructions inherited from Ingrid and Joyce, former co-editors of this newsletter. It has been fun producing this newsletter and we are both glad David has asked us to continue as co-editors for another year.
We welcome all feedback, even critical feedback; because it helps us correct our mistakes to ensure we produce a quality newsletter. Please let us know if you find an error or if there is something you feel we could do better.
Please e-mail us if you know of planned workshops in your facility, in your area, or nationwide that might be of interest to CRANE members. Also, please let us know about issues you would like to see printed in this newsletter.
Remember that this is your newsletter. Only you can help us make it better than it already is.
Pam Hinkle, CTR, Vermont
phinkle@giffordmed.org Hope Valcarcel, BS, RHIT, CTR hvalcarcel@emh.org
NOMINATING COMMITTEE REPORT
Your Nominating Committee for 2005 is comprised of Nancylee Campbell, Katrine Batcho, Judy Spealman, Judith Raymond and myself. Although we have just completed our 2004 Annual Meeting, it is NOT TOO SOON to consider volunteering for a committee or a position on the Executive Board for the coming year. Don't wait for the inevitable plea from the Nominating Committee next fall. Now is the time to considering giving something back to CRANE, which provides education, support and networking for all of us.
Thank You.
Joan Korslund, CTR
Nominating Committee Chair, CRANE
6
TREASURER’S REPORT
As this is the first report of the calendar year, it seems appropriate to review our finances. Net worth as of December 1, 2004 is displayed below.
ASSETS
Checking Account $18,361.19
CD $6,659.19
CD $9,044.63
Total Assets $34,065.18
LIABILITIES $0.0
NET WORTH $34,065.18
Another useful way to look at our finances is by cash flow. In the simplest terms, we had cash inflows of $22,357.22 and cash outflows of $23,613.26. Overall, our cash flow was $-1,256.04. Detail by month is displayed below.
Cash Flow FY 2004
Oct-04
$12,450.50
99.34
12,351.16
Nov-04
$4,007.47
16,343.71
-12,336.24
Dec-04
$980.00
1,400.88
-420.88
Jan-04
$2.01
60.18
-58.17
Feb-04
$1.87
7.32
-5.45
Mar-04
$2,654.59
2,564.96
89.63
Apr-04
$171.37
173.06
-1.69
May-04
$285.07
6,360.58
-6,075.51
Jun-04
$401.29
119.67
281.62
Jul-04
$250.53
2,258.34
-2,007.79
Aug-04
$1,082.50
458.56
623.94
Sep-04
$70.00
-6,233.34
6,303.34
Overall
$22,357.22
23,613.26
-1,256.04
We also track our income and expenses by category. Now that I have a printer, I have run a list of all categories and will begin to eliminate duplicates and assure that entries are correctly defined. In a future issue I will provide a chart, which shows where our income comes from and where we spend it.
Respectfully submitted,
Joan Burgomaster, RHIA, CTR
Treasurer, CRANE
7
Membership Report
2004 MA64%FL & NY1%RI13%CT2%VT4%NH13%ME3%
To date, the Cancer Registrars Association of New England has 199 members. Two members come from states outside of New England—Florida and New York. This year CRANE membership was extended to former NESCRA (North Eastern States Cancer Registrars Association) members. One hundred ninety-four members have an “active” status and there are five recorded associate members. Two of our active members are currently retired.
Membership applications were mailed out in January 2004 and a membership roster was published and distributed. Membership updates are published in the CRANE newsletter.
2005 Membership applications will be mailed to the membership in December 2004. CRANE members will receive a membership packet when they return their applications in 2005.
I’ve enjoyed serving the membership in 2004 and look forward to serving as Membership Chairperson again in 2005.
Respectfully submitted,
Deborah Perriello BA, CTR
CRANE 2004 Membership Chair
8
FOR IMMEDIATE RELEASE CONTACT:
Tuesday, August 31, 2004 NCI Press Office
301-496-6641
Study Finds Immune Therapy for Metastatic Breast Cancer Possible
Researchers at the National Cancer Institute (NCI), one of the National Institutes of Health, have found promising evidence that immune cell transplant therapy can help shrink tumors in patients with metastatic breast cancer. Similar therapies, which also involve transplantation of donated immune cells, have produced dramatic anti-tumor effects in leukemias and lymphomas — cancers of the blood and lymph, respectively. However, previous studies have not proven that such therapies have clinical effects on breast cancer.
Michael Bishop, M.D., NCI, led the study, which was published on the Journal of Clinical Oncology’s website on August 16*. Scientists at the Experimental Transplantation and Immunology Branch of NCI’s Center for Cancer Research studied 16 women with breast cancer that had progressed to an average of three metastatic sites after conventional treatments, including chemotherapy and hormones; six of these had tumor shrinkage after cellular immune therapy.
Bishop’s group gave study patients a treatment similar to a bone marrow transplant. Each patient received cells donated by a sibling. This transplant included lymphocytes — cells crucial to the immune system — and the adult stem cells that produce blood cells. The active, anti-tumor component of this cellular immune therapy regimen was a class of lymphocytes called T-cells, which attack and kill tumor cells.
The same qualities that make transplanted T-cells react against tumors — especially their pugnacious tendency to attack foreign cells — also make them dangerous to the transplant recipient. Because the recipient’s own immune system may attack donor cells, NCI scientists gave subjects an immune-suppressing chemotherapy regimen before the transplant. To help protect subjects’ bodies from the toxic effects of the transplant, scientists followed the chemotherapy with a course of transplant-conditioning drugs.
Each subject received transplants with the same concentration of T-cells. The initial transplants had a relatively low concentration of these cells; infusions given at 42, 70, and 98 days after the first transplant had exponentially increasing numbers of T-cells. Increasing the concentration over this time period helped NCI researchers isolate patients’ reactions to the transplant from their reaction to the chemotherapy and established T-cells as the active element in the transplant.
Six patients of the 16 had partial or minor responses to the treatment lasting an average of three months. The transplants had a toxic effect in many of the women, having not only anti-tumor activity but also attacking normal cells. This graft-versus-host disease (GVHD) was observed in a majority of subjects: ten had acute GVHD; of thirteen available for a follow-up examination, four had chronic GVHD.
“Although it was hoped that the women would garner clinical benefit from this research, the study was not designed to demonstrate that this immune cell therapy results in an improvement of outcome, specifically survival,” Bishop explained.
“The study demonstrated that immune based therapies, specifically the lymphocyte-based therapy we used, could result in tumor regression,” Bishop said. However, it is crucial to improve cellular immune therapy by lowering the risk of toxic effects, especially GVHD. Collaborating laboratories are currently testing specialized T-cells they hope will cause little GVHD while retaining strong anti-tumor effects.
“These data provide support to continue efforts to develop better immune-based therapies to augment currently available therapies for metastatic breast cancer,” which is critical since current chemotherapies for the disease result in an average survival of only 24 months.
For more information about cancer, visit the NCI web site at http://www.cancer.gov or call NCI’s Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).
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* Bishop, MR, Gress R. “Allogeneic Lymphocytes Induce Tumor Regression of Advanced Metastatic Breast Cancer.” Journal of Clinical Oncology. Vol. 22, number 19. October 1, 2004.
TUMOR REGISTRY ASSISTANT
Baystate Health System, Cancer Services
3400 Main St., Springfield, MA.
DESCRIPTION: Responsible for gathering data on patients diagnosed and treated for cancer at the Baystate Medical Center. Includes participating in and preparing data for abstracting, with accuracy and completeness, correcting and revising data as appropriate, and completing follow-up data as assigned. Must update the cancer registry in accordance with Massachusetts state law and American College of Surgeons standards. Performs related duties as assigned.
REQUIREMENTS: Associates Degree in related field or 3-5 years related experience. Tumor Registrar Certification required upon eligibility. Good communication and organizational skills. Demonstrates good working relationships with other staff and physicians and exhibits a team spirit approach to problem solving. Must work autonomously and be self-directed. Knowledge of medical terminology and anatomy and physiology. Ability to use PC and Word Processor.
The salary range for the position is $11.30 - $18.05.
Interested candidates should contact Ann Urban
Telephone: 413-794-1703. or
Fax: 413-794-3325.
Email: ann.urban@bhs.org
ONCOLOGY REGISTRAR COORDINATOR
North Shore Cancer Center
The NSMC Cancer Center is the North Shore's leading cancer program. It works closely with Massachusetts General Hospital Cancer Center to offer a multidisciplinary program of care. Our medical, surgical and radiation oncologists are in one convenient location in Peabody, MA. Using the most advanced technology, innovative research, and a wealth of responsive and supportive services, we offer cancer care that you won't commonly find in a community setting. The Oncology Registrar Coordinator is responsible for maintaining and meeting all standards set by the State and the ACoS in regards to running a Cancer Registry Department. He/she ensures that the department meets all necessary standards of performance as set by the State, ACoS and NSMC Cancer Center. Maintains up-to-date knowledge of computer software and hardware used in an oncology registry. Demonstrates excellence in communication skills and customer relations. Possesses the ability to coordinate multiple responsibilities to ensure appropriate production and work flow within this busy department. Supervises a part-time staff of two Oncology Registrars and one Follow-Up Service Coordinator. Must be a Certified Tumor Registrar with two years of college or equivalent. Must possess knowledge of anatomy and physiology, medical terminology, ICD-O coding. Must be knowledgeable of the American College of Surgeons' requirements for hospital-based cancer programs and knowledge of State of Massachusetts requirements. Must have a minimum of two years' experience in an oncology registry and be proficient in oncology registry software programs.
Apply online at: www.nsmc.partners.org
NSMC Human Resources,
Audrey Giannattasio, Staffing Specialist
NSMC, Dept.
81 Highland Ave
10
Salem, MA 01970
Fax: (978) 740-4928
NOTE: Please go to the CRANE Web site for additional Job Postings: www.crane.crane.org
CONGRATULATIONS, NEW CTRs!
Congratulations to the New England residents who passed the CTR examination in September!
Connecticut: Donna M. Connery
Maine: Douglas L. Light
Hope Valcarcel
Massachusetts: Deb A. Caron
Susan N. White
Rhode Island: Marie P. Mueller
Tara Szymanski
Please e-mail Deborah Perriello if you have passed the exam and your name is not on this list. Deborah’s e-mail is: dperriello@impac.com
ACoS UPDATE
There have been some revisions to the Cancer Program Standards 2004 since its implementation in January of 2004. Please go into the web site for details: http://www.facs.org/cancer/coc/standards.html.
Also, please see http://www.facs.org/cancer/coc/resourcetools.html for some valuable resources if your facility was recently surveyed. There are also some great resources for quality control of many areas of the Cancer Registry.
**************************
Coding Hint from COC Flash: Is This Class of Case 0 or 1?
A Class of Case 0 is assigned if the diagnosis is provided by the accessioning facility and all treatment is provided at another facility, or the decision not to treat is made at another facility. However, not all cases that are "diagnosed only" by a facility are Class of Case 0.
For any tumor diagnosed at your facility:
11
- If a decision not to treat is made at your facility, this cancer is Class of Case 1.
- If the diagnosis was made by an excisional biopsy of the primary site, this cancer is Class of Case 1.
- If any procedure coded as treatment according to FORDS was provided at your facility, this is Class of Case 1 (See FORDS Revised for 2004, pages 28-28I).
- If your facility provided palliative care as part of or in lieu of first course treatment, this is Class of Case 1.
- If the treatment plan was "watchful waiting," this is Class of Case 1.
- If all or part of first course treatment was provided in a staff physician's office, this is Class of Case 1.
- If it is unknown whether any treatment was recommended or provided
FORDS UPDATE
One copy of the new FORDS: Revised for 2004 can be downloaded free from http://www.facs.org/cancer/coc/fordsmanual.html. A hard copy can also be ordered online or by mail for $30. For information, please see http://www.facs.org/commerce/2004/catsplash.html.
CANCER SURPRISE
HealthDay News 7 November 2004 Chicago Tribune
Eating plenty of fruits and vegetables may be good for your heart health, but a new study finds it won't lower your overall risk of developing cancer.
The study belies long-standing recommendations that people increase their consumption of fruits and vegetables to ward off cancer. Experts were quick to point out, however, that the latest research applies to any cancer, adding that such a diet could still prevent specific malignancies, such as tumors of the colon or bladder.
Harvard doctors found a 28 percent reduction in cardiovascular risk among nearly 110,000 health professionals surveyed for lifestyle patterns and medical history who include at least five servings of fruits and vegetables in their daily diets. However, they found no reduction in cancer rates among those who ate five or more servings of fruits and vegetables.
The results appear in the Nov. 3 issue of the Journal of the National Cancer Institute.
"These results are not entirely surprising," said Marji McCullough, a nutritional epidemiologist at the American Cancer Society, because the study surveyed the effects of fruit and vegetable consumption on all kinds of cancer, rather than just the ones that have shown some risk reduction from dietary habits.
"I still think there are reasons to believe that fruits and vegetables might impact specific cancers, like colorectal and bladder cancers," McCullough said. "Just because the association wasn't strong for cancer doesn't rule out a role for fruits and vegetables in cancer. Eating a healthy diet, for instance, may help prevent weight gain that we know is associated with cancer."
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CERVICAL CANCER VACCINE WORKS WELL
ANGELA STEWART 2 November 2004 The Star-Ledger
The world's first vaccine to prevent cervical cancer got a major boost yesterday when test results suggested it can provide long-lasting protection for teenagers and young women at high risk of the disease.
Four years after being vaccinated, 94 percent of participants in a study were protected from becoming infected with the virus that causes most cervical cancers. None of the women, who ranged in age from 16 to 23, developed any worrisome precancerous conditions, either.
The vaccine is made by Merck & Co. of Whitehouse Station, which funded the study led by researchers from the University of Washington. The researchers presented results yesterday in Washington, D.C., during a meeting of the American Society for Microbiology.
"These results are extremely encouraging. They demonstrate the vaccine will be very long-lasting," said Eliav Barr, the doctor who is leading development of the vaccine for Merck.
The company plans to seek approval from the U.S. Food and Drug Administration next year for an expanded version of the vaccine that could prevent another 10 to 20 percent of cervical cancers, in addition to providing protection against genital warts in both men and women.
New Jersey gynecologists were excited by the study results. One of them, Allison Wagreich, a gynecological cancer prevention expert at the Cancer Institute of New Jersey, pointed out that precancerous conditions are much more common than cervical cancer itself.
While 10,520 women will be diagnosed with cervical cancer this year in the United States, and about 3,900 will die from it, about a half-million women will develop precancerous lesions, she said.
"Obviously, there is a huge number of women who have abnormal pap smears and have anxiety about whether or not they are going to get cervical cancer. . . . Anything that could help these women would be wonderful," she said.
Virtually all cases of cervical cancer are caused by infection with human papilloma virus, or HPV, which is spread through sex. One particular strain, HPV-16, accounts for about half of all cervical cancers. In New Jersey, about 380 new cases of cervical cancer will be diagnosed this year, according to the American Cancer Society.
Barr said the vaccine would be recommended for young adolescents, with the idea being to immunize them before they become sexually active. He cited the ideal age group for vaccination as girls between 12 and 14 or 10 and 14, although revaccination might be advisable later.
He conceded that women who got the shot reported pain and tenderness at the injection site, as opposed to those who received a placebo. But Barr described the symptoms as "short in duration" and "mild or moderate in severity."
The new study followed 755 of these women for a period of four years after they were vaccinated. Seven had become infected, but none developed precancers. In a comparison group of 750 women who received dummy shots, infections occurred in 111 and precancers formed in 12.
Results bolster a previous study showing that HPV-16 infections were completely prevented in 768 women who had received the Merck vaccine 18 months earlier. None of them developed precancerous conditions, either.
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CANCER DATA MANAGEMENT PROGRAM
NORTHEASTERN UNIVERSITY
The Health Information Administration Program at Northeastern University has developed and launched a certificate program in cancer registry/cancer data management. The program was initiated in 1997 and received endorsement from the Committee of Formal Education of the National Cancer Registrars Association (NCRA) and the National Board for Certification for Registrars (NBCR) in 1998. Students who complete the Cancer Data Management Certificate Program are eligible to sit for the Certified Tumor Registrar (CTR) examination.
The program was developed using the cancer registrar essentials of the NCRA along with the expertise of Ms. Dianne Hultstrom, RHIT, CTR (Assistant Consultant and Instructor) and Ms. Nancy Hinchliffe, RHIA, CTR (Instructor). The program is administrated as an adjunct program through the Health Information Administration Program, which is accredited by the Commission on Accreditation of Allied Health Education Program (CAAHEP).
The Cancer Data Management program consists of two components:
• Core component, which includes Anatomy and Physiology, Pathophysiology, Medical Terminology and Introduction to PC Software.
• Professional component, which includes Cancer Registry Organization and Operation, Abstracting and Coding 1 and 2, and Cancer Data Utilization and Statistics.
The Cancer Data Management Program at Northeastern University is proud to announce that over 90% of the students who have taken the Certified Tumor Registrar examination have successfully passed and hold a CTR credential. For additional information, contact Annalee Collins, M.Ed., RHIA, Program Director, Health Information Administration Program, at (617) 373-2525.
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Young Women's Cervical Cancer Risk Very Low
FRIDAY, Nov. 5 (HealthDayNews) -- Adolescent and college-age women with abnormal findings on their Pap smear shouldn't hit the panic button, a new report suggests.
In the vast majority of cases, these abnormalities simply clear up on their own, the study found.
The research may also help resolve the issue of whether colposcopy -- a more invasive, expensive follow-up test -- is always warranted in this younger age group.
"The take-home message is that the majority of women with [Pap test] abnormalities who are at or under college age don't need to rush out and get colposcopy," said Dr. Thomas C. Wright, a professor of pathology at Columbia University in New York City, and lead author of cervical cancer screening guidelines issued by the American Society of Colposcopy and Cervical Pathology.
The advent of the annual Pap smear dramatically reduced the incidence of cervical cancer in American women. Current American Cancer Society (news - web sites) guidelines recommend that adolescents and college-age women see their gynecologist for a once-a-year Pap test within three years of first sexual intercourse, or by age 21, whichever comes first.
According to Wright, a small number of women -- about 1.6 percent -- will receive a Pap test result that includes a finding of "low-grade squamous intra-epithelial lesions" (LSIL). These microscopic lesions are usually linked to the presence of a very common, potentially cancer-causing pathogen known as the human papilloma virus (HPV). About 70 percent of women will become infected with HPV at some point during their lifetime, the American Cancer Society reports.
While most of these low-grade lesions appear to be harmless, in rare cases they can progress to high-grade lesions. Doctors usually treat high-grade lesions to prevent them from turning into cancers.
In older patients with Pap smears that indicate LSIL, gynecologists often choose to examine the affected cervical tissue with an instrument called a colposcope.
But is this expensive, invasive follow-up test always necessary in young patients with LSIL test results?
In a study in the Nov. 6 issue of The Lancet, Dr. Anna-Barbara Moscicki and colleagues at the University of California, San Francisco, examined 10 years of data on the cervical health of nearly 900 patients between 13 and 22 years of age. All of the women received Pap smears once every four months during the course of the study.
About 187 of these young women received at least one LSIL test result during the study period, the researchers reported. However, 61 percent of these low-grade lesions simply disappeared on their own within a year after diagnosis, with that rate rising to 91 percent by three years post-diagnosis, according to the investigators.
The findings confirm "the benign nature of this condition in adolescent and young women," the researchers said.
In an accompanying commentary in the journal, British Drs. Anne Swarewski and Peter Sasieni said they believe the UCSF team has "clearly shown just how common and meaningless LSIL is in young women." They concluded there is "no role for colposcopy in adolescents as part of routine [gynecologic] management."
But Wright said he wouldn't go quite that far.
He agreed with the British doctors that "there is a very low rate of significant disease among adolescents, especially. What we'd classify as 'disease' here is usually nothing more than an acute viral infection that usually goes away."
On the other hand, he said, the study "isn't saying that we don't do follow-up" when young women receive a Pap test result with LSIL.
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"The study authors are just saying 'wait a while' before initiating colposcopy. I do think that's the right tack -- it's not that you don't ever need to do colposcopy, it's that you don't need to do it immediately," Wright said. "First, give the lesion a chance to regress."
If the lesion persists through subsequent Pap smears, colposcopy may be warranted, even in young women, he said.
However, the new study should ease the fears of young women who receive abnormal Pap results. According to Wright, the findings offer up yet more proof that "cervical cancer or significant disease is very uncommon in this age group."
Web Sites for Interesting Articles too Lengthy to Copy in
Newsletter
Calretinin Staining May Help Distinguish Schwannomas From Neurofibromas http://mp.medscape.com/cgi-bin1/DM/y/hjRb0EJHpJ0D1F0GDLG0Al The pattern of calretinin staining suggests that schwannomas and neurofibromas might originate from distinct Schwann cell types. Medscape Medical News 2004
Targeted Therapies for Cancer 2004
http://www.medscape.com/viewarticle/481608?src=search This review highlights the history of targeted anticancer therapies, focusing on the development of molecular diagnostics for hematologic malignancies and the emergence of trastuzumab.
American Journal of Clinical Pathology
End of an Era for PSA Screening: A Newsmaker Interview With Thomas Stamey, MD http://mp.medscape.com/cgi-bin1/DM/y/hjRb0EJHpJ0D1F0GCsY0Ah During the last 5 years, the predictive value of prostate-specific antigen levels for prostate cancer was only 2%, but there was a greater correlation with benign enlargement. Medscape Medical News 2004
Alcohol Consumption Does Not Raise Risk of Bladder Cancer
http://bmj.bmjjournals.com/cgi/content/full/329/7471/883 New research suggests that alcohol consumption does not increase the risk of bladder cancer. In fact, intake of one particular beverage -- beer -- may actually reduce the risk, according to the report in the Journal of the National Cancer Institute for September 15. BMJ Publishing Group @ bmj.com
Breast Cancer Associated With Melanoma Risk, and Vice Versa
http://www.cancerpage.com/news/article.asp?id=7518 There appears to be a bidirectional association between female breast cancer and cutaneous melanoma, according to results of a new study. While the finding might be confounded by increased surveillance in the two diseases, it does support increasing evidence of an overlapping genetic pathway. Reuters Health Information 2004
Metastatic Thyroid Cancer http://mp.medscape.com/cgi-bin1/DM/y/hjZN0EJHpJ0D1F0GELd0A4 This case illustrates a thorough knowledge of potential causes of false-positive findings is important for the accurate interpretation of radioiodine whole-body scans. Appl Radiol 33(9) 2004
Dogs Sniff out Bladder Cancer http://mp.medscape.com/cgi-bin1/DM/y/hjZN0EJHpJ0D1F0GDXT0Ay The acute sense of smell that makes dogs useful for detecting illegal substances at airports might also be applied in an oncology setting, researchers reported this week. Reuters Health Information 2004
Computer-Aided Diagnosis May Reduce Unnecessary Breast Biopsy
http://mp.medscape.com/cgi-bin1/DM/y/hjqm0EJHpJ0D1F0GFpL0AC Results of a study provide more evidence that radiologists are better able to correctly characterize malignant and benign breast masses on serial mammograms with the aid of a computer program. Reuters Health Information
Revised Colon Cancer Staging Provides Better Survival Estimates
http://mp.medscape.com/cgi-bin1/DM/y/hjqm0EJHpJ0D1F0GFl30Ah By providing more substages, the recently revised American Joint Committee on Cancer (AJCC) staging system for colon cancer, "stratifies survival more distinctly" than its predecessor. Reuters Health Information
Red Wine Consumption May Lower Prostate Cancer Risk
http://mp.medscape.com/cgi-bin1/DM/y/hjqm0EJHpJ0D1F0GFlc0AV Moderate consumption of red wine might lower the risk of
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prostate cancer in men who drink. Reuters Health Information
Genomic Factors Augment TNM Staging in Squamous Cell Head and Neck Cancer
http://mp.medscape.com/cgi-bin1/DM/y/hjyy0EJHpJ0D1F0GGR10Aa Genomic analysis of squamous cell carcinomas of the head and neck reveals a recurrent pattern of chromosomal aberrations associated with disease outcome. Reuters Health Information
Disclaimer: The Web Sites above have been selected for their potential interest to CRANE members. The editors hope that these sites will provide useful information but cannot vouch for their content. It is up to the respective user to decide the appropriateness of each Web site.
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Medical Record Associates, Inc. P.O. Box 88 Milton, MA 02186 (617) 698-4411
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Cancer Registrars Association of New England
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Hope Valcarcel, RHIT, CTR
PO Box 477
Milford, ME 04461-0477
QUESTIONS?
Contact: Pam Hinkle
phinkle@giffordmed.org Hope Valcarcel hvalcarcel@emh.org
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