Sutter Health Cancer Services and Programs

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B l o o d a n d M a r r o w Tr a n s p l a n t a t i o n P r o g r a m sProgramsat Sutter HealthTreatment OptionsThe two types of BMT (autologous and allogeneic) differ with respect to theorigin of the cells infused into the patient following the BMT treatment regimen.Autologous BMT involves re-infusion of the patient’s own stem cells collected priorto start of the treatment regimen. While it is more available and carries very lowmortality, it is not indicated for all diseases. Allogeneic BMT requires the collectionof stem cells from a matched donor and is primarily used in situations where thepatient’s own hematopoietic system is diseased. Therefore, it is less available andunfortunately more toxic, with a higher risk of death because of immune differencesbetween the patient and recipient, which cause Graft-vs.-Host disease. Donors canbe either family members or unrelated donors. At present the Sutter programsperform only matched-sibling donor transplants.Recent advances in BMT have widened the spectrum of diseases treated with BMT.Until the late 1990s, very high doses of chemotherapy were used in allogeneic BMTto “ablate” (destroy) the marrow of the patient. Recent studies have shown that“non-myeloablative” doses of chemotherapy are enough to allow the stem cells ofthe donor to settle and grow (“engraft”) in the patient. With time, these stem cellstake over and produce all the blood cells for the patient. They can also see the canceras a foreign antigen and thereby fight it, a phenomenon known as “graft-vs.-tumor”effect.Non-myeloablative or “reduced intensity” BMT is less toxic than traditionalallogeneic BMT, thereby allowing older patients to benefit from the procedure.It is also very useful in patients where the main purpose of the procedure is toinduce a graft-vs.-tumor effect, such as in low-grade lymphomas, indolent bloodmalignancies and most recently some solid tumors such as kidney cancer. Theseadvances have resulted in long-term disease-free survival for a number of heretoforeincurable diseases.30 | 2005 Annual Cancer Center Report — 2004 Statistical Review
O v e r v i e w o f C a n c e r R e g i s t r i e sRegistriesSutter Cancer ProgramStephen BishopCancer Data Services CoordinatorAlta Bates Summit Medical CenterCancer Registry Data CollectionAnd AnalysisThe cancer registries of the SutterCancer Program provide datamanagement services to comply withmandatory state cancer reportingregulations, as well as the data needsof clinicians, administrators andother qualified users across the Sutternetwork. In addition, Sutter CancerRegistries provide data to nationallevelcancer surveillance organizationsfor incidence measurement andepidemiological studies. The SutterCancer Registries contain data for182,659 cases; 9,589 new cases wereentered in the 2004 calendar year.The local registry databases containdemographic and clinical informationfrom diagnosis through treatment, aswell as annual lifetime follow-up data.The follow-up process, in addition toproviding critical information aboutdisease status and treatment outcomes,also performs a valuable service forphysicians and patients by remindingthem that regular reassessment of thedisease is vital for early detection ofrecurrences or subsequent primaries.As of the end of 2004, the Sutter CancerRegistries are actively following 61,581living patients.Data collected by each hospital areshared and aggregated for reports, studiesand cancer statistics for the SutterCancer Program as a whole. The abilityto look at our combined Sutter Healthdata provides a unique opportunity toRadiation therapists monitor the Radiation Oncology room at Alta Bates Comprehensive Cancer Center.evaluate care across our network. Atpresent, systemwide studies and qualityassurance projects are accomplishedthrough data exports and manualaggregation, and statistical analysis ofthe data. Through comparison with regionaland national statistics, the combineddata enables Sutter clinicians tomore effectively monitor trends in theincidence, staging, treatment, outcomeand survival of cancer patients treatedwithin our network.In addition to their routine cancerregistry responsibilities, Sutter cancerregistrars are often asked or volunteerto coordinate or participate in othercancer program activities outside ofthe cancer registry. At any of the nineACoS-accredited facilities in the SutterCancer Program, the cancer registrarmay coordinate or supervise cancerscreening programs, cancer supportservices, continuing medical educationfor oncology, cancer research, orvolunteers and auxiliary staff members.Sutter cancer registrars are oftenmembers of other standing medicalstaff or hospital committees, especiallyquality improvement committees.Cancer registrars often participate inor coordinate American Cancer Societyactivities, community health fairsand public education activities suchas Breast Cancer Awareness Monthevents in October and Prostate CancerAwareness Month events in November.2005 Annual Cancer Center Report — 2004 Statistical Review | 31
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