May 18, 2013
Doctors team up to tackle difficult cancer cases
by BY DANN DENNY Associated Press
Jan 09, 2013 | 132 views | 0 0 comments | 1 1 recommendations | email to a friend | print
BLOOMINGTON, Ind. — It’s 7:30 a.m. in IU Health Bloomington Hospital’s Medical Staff Conference Room, and about 20 doctors, nurses and specialists are having their weekly cancer conference — a two-hour discussion of how to best treat cancer patients with particularly challenging cases.

The first of six cases to be discussed today involves a 70-year-old woman who had ovarian cancer more than 20 years ago who was treated with chemotherapy and a hysterectomy, and who is now battling breast cancer.

The discussion is peppered with plenty of “doctorspeak,” replete with references to such things as “spiculated masses,” ‘‘infiltrating ductal adenocarcinoma with lobular features,” and “mildly hypermetabolic focus in the breast.”

Radiologist Bruce Monson, displaying an ultrasound of the woman’s right breast on a large video screen, manipulates a yellow arrow to point to a “highly suspicious” 3-centimeter mass in the breast tissue.

Then pathologist Eric Stevens, the meeting’s coordinator, picks up a slide containing a stained slice of that mass and inserts it onto a microscope — which projects an enlarged image of the tissue on a screen.

“As you can see, the tumor has primarily a strandlike growth pattern that is infiltrating through here,” Stevens says. “The tumor is showing some positivity for E-cadherin, but it’s fairly weak.”

Stevens said the regular cancer conference is required by the American College of Surgeons Commission on Cancer for any cancer program in the country that wants to be accredited by the organization.

“We get inspected every three years by a trained surveyor from the Commission on Cancer to make sure our program is still meeting all the accreditation requirements,” Stevens said. “One of those requirements is that we have regular breast cancer and multidisciplinary conferences. We are also required to submit specific data yearly to the Commission on Cancer as well as the National Cancer Data Base.”

Martha Hill, IU Health Bloomington’s lead cancer registrar, said the commission also requires accredited cancer programs to maintain a cancer registry with follow up exceeding 80 percent of its overall cases and 90 percent of the last five years of cases, and offer such things as palliative care services and continuing education for its cancer team members.

Hill said IU Health Bloomington also is accredited by the National Accreditation Program for Breast Centers, which has its own standards and guidelines that must be followed. “By having accreditation it shows we have exceeded the standard of care set forth by the governing bodies,” Hill said.

Stevens said being an accredited cancer program “lets patients know that we have high quality cancer services at IU Health Bloomington, and that they don’t need to travel far from home to get excellent cancer care.”