Many lives are touched by cancer. The work of cancer registrars is helping
to change that.
Linda Mulvihill is a National Cancer Registrar's Association (NCRA) board
member. She is proud of the work that cancer registrars do.
In more than 20 years in the field, Mulvihill has seen how cancer registrars'
work contributes to a tremendous change in cancer treatment and prevention.
For example, the drop in breast cancer rates relates in part to cancer registry
data showing a link between breast cancer and women taking estrogen. Statisticians
projected the numbers, but they had to have data to work with. "How would
they know the numbers if we didn't count them?" she asks. "We're the ones
that supply the factual data."
Mulvihill says she entered the field because she likes science and enjoys
details. "I don't think I would be well-suited for patient care," she adds.
The need for constant learning is challenging, however. Cancer registrars
must keep up with changing computer and medical technology. They must also
keep up with constantly changing codes. "It's becoming increasingly difficult
because the changes are coming at us so quickly," she explains.
Carol Russell agrees that keeping up with the changes is the hardest part
of the work. Russell is the manager of a cancer registry. She says that the
coding rules change yearly. This means that the coders must be able to learn
new codes regularly. They must also understand codes used in years past. They
will encounter old codes when they are compiling records.
"You really have to like to code," Russell says. "You have to think about
the things you are coding and abstracting."
With so many changes, it's not surprising that coding mistakes can happen
-- and they sometimes lead to funny stories. For instance, one hospital noticed
registry data showed an unusually high number of male patients with breast
cancer. When they looked at individual records, they found the patients had
names like Mary and Susan. It was a slip of the finger. A registrar had accidentally
used the code for men instead of the code for women.
With more than 25 years experience, Russell believes that the work registrars
do makes a big difference. Shortly after starting her first job, Russell was
snorkeling with friends in Hawaii when a woman asked what work she did. After
she explained, the woman thanked her for being one of the people trying to
find a cure for cancer. "What she said has always stayed with me," Russell
tells us.
Cancer registrar Elaine Hamlyn agrees that the work is valuable, although
she adds that she would prefer to be unemployed in a world without cancer.
Hamlyn has worked for different agencies, and now works from home.
"My position might be unique in that I don't work for a specific agency
like most of my colleagues," Hamlyn explains. To Hamlyn, the most challenging
aspect is ensuring the data set is complete. When you are abstracting a case,
you have to be sure to have all the information pertaining to that case. The
head and neck is the most challenging anatomical site. There are many codes
in such a small area.
Other than that, Hamlyn wishes that cancer registrars would receive more
recognition. Many people do not understand their role. "We are constantly
trying to raise the profile of what we do," she says.
Hamlyn says the work offers a lot of opportunity and variety. People can
stay at the ground level if that is what they like to do. But some develop
an interest in a certain topic and become a specialist in the area. For instance,
some might specialize in quality improvement, or they might have site-based
specialties such as the head and neck. "These people are the resources that
we like to draw from," she comments.
Steven Peace is a senior study director for a private research company.
He works on a large national lung cancer screening trial. Peace entered the
field 25 years ago with a degree in management information systems. He discovered
cancer registrar work almost by accident.
During his career, Peace has worked for various central cancer registries.
He has managed a single and multi-hospital cancer registry. He has worked
on clinical trials for an oncology group. He has published his writing. His
education and wide range of experience gives him specific skills to work on
the projects that he does.
Peace describes his current work as a liaison activity that bridges the
medical information management group with the clinical management group. "The
info management people talk geek talk and the clinical people talk doctor
talk," he laughs. His role is to help them communicate with each other.
Like the others, Peace describes his career as rewarding. Over the years,
he came to recognize that his work has a great deal of value.
He enjoys the constant new learning. "Also, I like to see my name in print,"
he jokes. "I can Google myself and find stuff which is kind of fun."
Peace's knowledge has also served him in his personal life. When Peace's
father received a cancer diagnosis, Peace explained the situation to him in
a way he would be able to understand. "I've served in that role many times
over for family, friends and strangers," he comments. "I've seen more cancer
patients than many physicians."