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GATRA CONNECTION

SPRING 2004

News & Views of the Georgia Tumor Registrars Association

Premiere Electronic Version

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Message from the President

We have an excellent Executive Committee in place for the upcoming year. Several projects are already in the works by committee members. I feel very fortunate that I will have the opportunity to work with such an energetic and caring group of professionals. What makes them even more special is the fact that a lot of them came to me and volunteered to serve on a committee. I did not have to beg or coerce any of them.

One of the main functions of the organization is to provide the membership with professional development and continuing educational opportunities. I felt the best way to accomplish this was to have the Education Chair (Dolores McCord) and her committee focus only on the fall meeting, and I assigned the duties of the two CTR preparation workshops to Ann Hatfield and Jennifer Ruhl. And WOW!, They have all been hard at work. As you will see when you read Dolores’ education report, the dates and location of the fall meeting have already been set. When was the last time you knew by March when and where the meeting was going to be? The February CTR Workshop was a great success. In spite of the weather scare, all 7 speakers and 13 attendee’s from all over Georgia, Alabama and Tennessee made it to the workshop. The workshop was hosted by the Wellstar Health System Cancer Program in Marietta, GA on February 27th and 28th. Wellstar also donated the food and beverage for the meeting. Great Job Ann! The August CTR workshop will be hosted by the Medical Center of Central Georgia in Macon. Please contact Jennifer for more information.

I want to encourage members to frequently visit the GATRA website: . The website is an excellent communication tool. We will be using it as a means to educate and inform members of GATRA functions, educational opportunities, announcements and job postings. Dolores and her son have done a wonderful job on the website. Thank you Dolores for the all the hard work you and your son have put into the website.

Penny Goodell, CTR

GATRA 2004 EXECUTIVE BOARD

Position Name E-mail Phone #

President Penny Goodell pgoodell@ 770-443-9660

Vice-President Jennifer Ruhl jruhl@ 912-466-2911

President-Elect Debbie Chambers debbie@ 912-633-1902

Secretary Ann Hatfield ann.hatfield@ 770-732-4647

Treasurer Debra Fortier dfortier@ 678-442-4194

Immed.Past Pres. Cheryl Wheeler cwheeler@ 706-774-8094

Committee Chairs

Education Dolores McCord mcdove@ 404-605-3488

Membership Joy Thompson joyt@ 706-675-9270

Publicity/Newsltr. Anna Muza amuza@ 706-774-8093

Mercedith Cardona mnazario-cardona@uh.og 706-774-2843

Ways & Means John Cummings jcummings@ 678-442-4471

Historian Lori Lindsey cdms@ 706-646-4182

Nominations Patricia Fordham patricia.fordham@ 478-765-4157

Election Sherri Bailey sherri.bailey@ 706-802-3536

By-Laws Diane Stapleton diane.stapleton@ 770-793-7491

Cancer Control Carol Crosby ctcrosby@ 229-430-6388

Audit Wanda Kemp wanda.kemp@ 770-533-8822

Liaisons

NCRA Penny Goodell pgoodell@ 770-443-9660

GCCR Diane Stapleton diane.stapleton@ 770-793-7491

Ad Hoc

Website Dolores McCord mcdove@ 404-605-3488

NCRA Ann Hatfield ann.hatfield@ 770-732-4647

Annual Conference Scholarship Fund

Education Committee Update

Dolores McCord, RHIT, CTR

Reflections of Change: Past, Present, and Future

The 2004 Fall Meeting of the Georgia Tumor Registrars Association will be held at the Kennesaw State University’s Continuing Education Center, September 29, 30 and October 1. The KSU Center offers state-of-the-art technology and spacious meeting rooms. The area offers no less than seven quality and inexpensive motel options, as well as a multitude of restaurants, shopping centers and other avenues of entertainment.

The meeting program offers (approximately) 11 hours of continuing education credit hours (application will be made to NCRA for CE hours). Planned topics include an in-depth review of Lung Cancer, including coding and abstracting exercises; a review of prostate cancer and breast cancer—recognizing both Prostate Cancer Awareness Month in September and Breast Cancer Awareness Month in October; and a discussion of Pediatric cancers. State and CDC updates are planned, as well as breakout sessions—basic and advanced. The new CoC Standards and the new Survey process are also planned for discussion. And no meeting is complete without door prizes and multiple raffle opportunities.

What to do? What to do! What to do?!?! When you aren’t in the meeting, you’ll have some difficulty in deciding What To Do. KSU is hosting the Ann Frank Exhibit, with free, self-guided tours of an incredible piece of history – including a section of the Berlin Wall. The KSU center is less than five miles from Town Center Mall at Cobb, where you'll find fabulous fashion, exceptional eateries, delightful diversions and superb shops. Kennesaw Mountain National Battlefield Park is nearby, with the most complete Civil War battlefield of the 1864 Atlanta campaign and more than 11 miles of original earthworks. Historic Kennesaw offers quaint shops as well as The Southern Museum of Civil War and Locomotive History; Home of the Famous Civil War Locomotive, The General.

In nearby Marietta, you’ll find the Marietta History Museum, Marietta National Military Cemetery, Marietta Confederate Cemetery, The Historic Village at Life University, The Gone With The Wind Movie Museum Scarlett on the Square, not to mention the numerous restaurants and shops.

Look for more meeting information in the coming months.

Ways and Means Committee Update

John Cummings

Plans are being made for a very successful year of fundraising to support our organization, and all members of GATRA can help! First of all, if you attended the Fall Education Conference in Savannah last year, you’ll remember that we raffled baskets filled with great local gifts, food specialties, and other unique items from different areas of Georgia that were contributed by each region (Southwest, Central, North, Southeast, and Metropolitan Atlanta). The basket raffle was very popular, and we've decided to do it again this year! Please think of items to put in your region's basket that are examples of why your part of Georgia is such a great place to live and work (the raffle ticket price will be $1 each). Your Regional Coordinator will be collecting items to include in your region's basket (feel free to send them on to her if you have them ready!). We'll share more details in upcoming newsletters, but this year's Fall Conference will be here before you know it, so start thinking about your registry's contribution!

Secondly, we are the beneficiaries of an unusually generous gift that promises to generate a lot of interest. Karie Manton, the daughter of GATRA member Sharon Manton, CTR; is a professional woodworker who creates outdoor Adirondack-style furniture that is both beautiful and very comfortable. Karie has agreed to donate two chairs, two footstools, and a side table to GATRA, and we will sell tickets to raffle this handmade furniture at the Fall Conference! Because of the unique nature of Karie’s donation, we want to begin selling tickets for the raffle prior to the Fall Conference, so that non-GATRA members - co-workers, family & friends may also purchase tickets. Tickets will be priced at $2 each, or 3 tickets for $5. Very soon, we will be mailing a supply of tickets to each GATRA member, along with a description of the pieces (and hopefully photographs of samples of Karie’s work). Again, more information will be forthcoming shortly, but any questions can be directed to John Cummings at Gwinnett Medical Center in Lawrenceville - telephone 678-442-4471, or e-mail jcummings@.

With everyone’s help, we can have a terrific year raising the funds we need to keep GATRA fiscally healthy!

Scholarship Update:

Ann Hatfield, CTR

Watch for upcoming information regarding the GATRA Scholarship – for a chance to attend NCRA’s 2005 annual meeting. Details to be posted on GATRA’s website () soon!! For more information contact Penny Goodell @ 770-443-9660 or Ann Hatfield @ 770-732-4647.

NCRA Update:

Ryan Intlekofer, RN, CTR

Immediate Past President – NCRA

The past year has been a busy one for the NCRA board and committees. In the area of education, the board is finalizing a management plan that will take NCRA’s educational programming to the next level and beyond. Education has become the major focus that it should be, in the forefront of all other NCRA activity. The plan includes a provision for obtaining additional grant funding to support the development of many different types of educational opportunities, from web-based training to regional meetings. When the finishing touches are finalized, I will provide updated information.

The education committee has updated the pre-certification workshop to incorporate changes in reporting requirements and a basic cancer registrars training program is in development.

Progress in Certification includes web based testing for the Certification exam. This is being done through Laser Grade Testing Inc.’ s computer based testing facilities. There are multiple testing sites throughout the US at over 700 testing centers. NCRA’s Council on Certification will continue to offer the exam in both March and September and using the computer based testing allows the participant to pick any day within a two week time frame to sit for the exam. Exams are given Monday – Saturday, excluding holidays. The deadline for application for the March 2004 exam has expired. The March exam will be administered between March 13-27, 2004. The deadline for application for the September exam is July 31, 2004 and exam will be offered between September 11-25, 2004. Additional information about NCRA’s certification process can be found on the NCRA web site: ncra- under the heading Certification.

If you have not accessed the NCRA web site in awhile, you will notice a few changes in the design and amount of information available to you. The members-only section allows access to the membership list, and other important documents such as bylaws, ethics and policies and procedures.

At the last board of directors meeting, the board voted that NCRA or our Executive Director join each state association to allow for better communication with the states.

The NCRA board made some progress in regards to recognition of cancer registrars in January following the board meeting. Members of the NCRA board went to Capitol Hill where they met with Senators, Congressmen and staffers to discuss the role of cancer registrars in the fight against cancer.

The NCRA 2004 Annual Conference is approaching quickly. This is a special year as NCRA celebrates 30 years of progress. The meeting will be held in Portland, Oregon. It is not too late to register. For your convenience, registration can also be done online at the NCRA website.

For future planning, the 2005 meeting will be held in New Orleans, LA., during NCRW. Special events are planned as we celebrate our designated week together. The call for presentations will soon go out to the members. If you have a special interest or topic you would like to present, the time is right! Look for the call for presentations and get your outline submitted!

To be transported further into the future, the 2006 meeting will be held in Washington D.C., and in 2007, we go back to the future at the Las Vegas Hilton.

Thanks for reading!

New Drug Update:

Daryl Sirard, RHIT, CTR

Meet Y-90 and SIR-Sphere

A New Treatment for Liver Cancer

In some situations, inquiring minds want to know. Such was the case when abstracting a treatment and noting the term: Y-90. That was all I needed to start the Internet search for Y-90. The answer turns out to be quite interesting.

Y stands for Yttrium. Remember those chemical abbreviations back in High School Chemistry?

This method of treatment was first developed by Dr. Bruce Gray and the Cancer Research Institute in Perth, Australia in 1987. It is being used in Hong Kong, New Zealand, Australia and now here in the United States.

This is a procedure that works mostly for those with liver cancer when surgery is not feasible. Surgery may be possible when the tumor has been shrunk by the Y-90.

The Yttrium-90 which emits beta radiation, is placed into something called SIR-Spheres which are bio-compatible radio-active little micro spheres. The micro sphere is very small, about one-third the diameter of a strand of hair. They are placed into a syringe and when injected, travel into the blood stream. From there it targets the tumor in the liver. These Spheres are trapped in the blood vessels of the tumor. When the Spheres target the tumor the irradiation leads to the destruction of the tumor, a process called Selective Internal Radiation Therapy (SIRT).

Meanwhile, most of the normal liver tissue is relatively unaffected.

SIR-Spheres treatment is a regional treatment concentrated in the liver. There is little effect on other sites such as lungs or bones. It is not a cure but Clinical Trials have shown this method to shrink tumors better than chemotherapy. In fact, Clinical Trials showed a highly significant increase in the average time the cancer was kept in remission, and an increase in 2 and 3 year survival.

Everything has side effects and SIR-Spheres is no exception. Fever, abdominal pain and nausea are usual. Radiation pneumonitis and also radiation hepatitis can also occur. Most patients given this treatment usually go home the day after treatment and can resume normal activity.

All of this because of an inquiring mind wanted to know.

GATRA SALARY SURVEY 2003

Jennifer Ruhl, RHIT, CTR

In September 2003, it was brought to the attention of the Board of Directors that there was a need for a Salary Survey of Tumor Registrars in Georgia. GATRA had previously conducted a similar survey, but it was felt due to the rising cost of living, the new cancer reporting requirements and the changes in the profession, that a new survey was needed.

A form was developed by the 2003 GATRA Vice President and then sent to members of the Board of Directors. Several changes were made, and a final survey was approved and made available to the participants at the 2003 GATRA Fall Conference in Savannah, GA.

Several factors were taken into account when developing the survey and also when analyzing the final data. These included:

• Whether a cancer program was accredited by the American College of Surgeons

• CTR certification

• Annual analytic caseload

• The number of employees in the registry

• The main responsibility of the individual in the registry

• Location of the hospital

The following are the results of the survey:

Of the 74 participants, 44 were in Accredited programs, 13 were in non-accredited programs and 17 worked in a non-hospital environment. Participants were asked to check their main job responsibility. Comparisons throughout this report will be based on that factor.

Single employee registries account for 16 (21.6%) of the participating registrars. Of these 16, 8 are in accredited programs. For the accredited programs, annual analytic caseloads range from 275 to 800, with an average of 485. Three of the eight registrars are CTR certified. In the non-accredited programs, the annual analytic caseloads range from 150-400, with an average of 290. Five of the eight registrars are CTR certified. The salary ranges for the certified programs are $20,000-25,000 to $35, 000-40,000 with an average of $25,000-30,000. For the non-accredited programs, most of the salary ranges were in the $20,000-25,000 range. For both types of programs, higher salaries were earned by registrars who preformed other job tasks as well. A majority of these registrars are located in Southeast and Southwest Georgia, with a couple in North and Central Georgia. There were no registrars from Metro Atlanta in this area. Of the 16, only 2 had been to NCRA, while all 16 stated their hospital supported their involvement with GATRA.

Those who defined their primary jobs as abstractors comprised 22 (29.7%) of the participating registrars. Of those 22, 20 worked in accredited programs, 1 in a non-accredited program and 1 in a non-hospital environment. (Since 5 of the participants did not fill out their annual case load and/or their pay, only 17 participants will be compared. The non-accredited hospital will be included with the others.) The annual caseloads ranged from 650 to 3000 with an average of 1700 cases per year. For the registries with annual caseloads of 1500 or less, there was an average of 3 employees. For those over 1500, there was an average of 4, with the registries with annual caseloads of 2500 plus with 7 plus employees. Fourteen of the registrars are CTR. Salaries ranged from $20,000-25,000 to $35,000-40,000, with half of the registrars making $35,000-40,000. Twelve of the registrars worked in Metro Atlanta, with the remaining throughout the state. Of the 17, only 5 had been to NCRA, while all 17 stated their hospital supported their involvement with GATRA.

Those who defined their primary jobs as management comprised 15 (20.2%) of the participating registrars. Of those 15, 13 worked in accredited programs and 2 worked in non-hospital environments. The annual caseloads for the hospitals ranged from 900-3000, with an average of 1500. Eleven of the hospitals had less than 2000, with an average of 3 employees in the registry. Ten of the hospital registrars are CTR. Seven of the managers made $50,000 or greater, with the remaining 7 earning an average of $35,000-40,000. Five of the registrars worked in South Georgia, 2 in Central Georgia and the remaining in Metro Atlanta. Of the 15, 11 had attended NCRA, while all 15 stated their hospital supported their involvement with GATRA.

There were 9 state employees who participated, with 6 of them CTR, and salary ranges of $25,000 to greater than 50,000 and an average of $35,000-40,000. Three had been to NCRA and 8 stated support for GATRA involvement. Three employees were employed by the Federal Government and all stated their primary jobs included other areas other than cancer registry work. The remaining participants were involved in follow up, contracting, software and other.

Although not totally conclusive, the results of this short survey show that registrars working in accredited programs and larger cities tend to make higher salaries. There are several registrars who are CTR certified that are making lower than average salaries. Most of these registrars are working in the smaller programs, many of which are in non-accredited programs.

WELCOME NEW MEMBERS!

Cynthia E. Perry, CTR Rossville, GA

Anagha T. Cupples, BS Atlanta, GA

Karen Phillips, CTR St. Peters, MO

Esther Assi, MD Lilburn, GA

Lou Ellen E. Jayroe BS, CTR Dothan, AL

Ann F. Keller, RRA, RHIA North Augusta, SC

Teri A. Carter LaGrange, GA Jeanie C. Ray Macon, GA

Congratulations to Georgia’s new CTRs

Diane B. Alligood Dexter, GA

Patricia A. Bodine Columbus, GA

Jennifer M. Davidson Rentz, GA

Alicia L. Gibson Carrollton, GA

Diane G. Small Lithonia, GA

Diane M. Wade Lithonia, GA

Important Meeting Dates to Remember:

April 28-30, 2004

Georgia Comprehensive Cancer Registry Spring Training

Renaissance Atlanta Hotel, Atlanta, GA

Registration Deadline: April 14, 2004

For More Information Contact:

Nancy Sloan, 404-463-6249

Or go on-line to hrod.state.ga.us to view registration form and meeting schedule.

September 29-October 1, 2004

Georgia Tumor Registrars Fall Meeting

Kennesaw State University Continuing Education Center

Kennesaw, GA

For More Information Contact:

Dolores McCord, 404-605-3488

The Editors would like to THANK everyone who contributed to this newsletter. Most people volunteered to write their articles without being asked, which has made our job very easy.

We hope you all like the new format, and internet availability. If you experienced any problems, or have any suggestions for the future, please contact either Anna Muza, or Mercedith Cardona.

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