American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

June 2015 CoC Source

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CoC News

Call for Commission on Cancer Members

It is the time of year when we look for the next group of Commissioners for the Commission on Cancer (CoC).

The American College of Surgeons (ACS) is seeking six Fellows to fill vacancies on the CoC. The initial term of appointment is for three years with eligibility for re-election to a second term. Members may hold office or serve as a Vice-Chair of a committee or subcommittee during their second term. New members will be recommended by the Nominating Committee, selected in October by the Executive Committee, and then brought before the full CoC membership for approval at the CoC’s Annual Meeting. The ACS Board of Regents will confirm the final list of new members, and the CoC will announce the new members in late October.

Surgeons who meet the criteria below and are interested in becoming a member of the CoC should contact to receive an application. The completed application, curriculum vitae, and letters of recommendation must be sent to the same address no later than August 15

CoC member criteria include: 

  • Is not a former CoC member who represented the ACS Fellowship
  • Full ACS Fellowship status 
  • Staff appointment at a CoC-accredited cancer program and participate in cancer program activities 
  • Service as an effective State Chair or Cancer Liaison Physician (CLP)
  • Knowledge of the CoC’s goals and initiatives 
  • Represent a surgical specialty, geographic area, or diverse group not currently represented on the CoC 
  • Interest in contributing to and enhancing CoC programs and committee work 
  • Ability to serve as a member on at least one CoC committee 
  • Attendance and participation in at least two in-person meetings annually
  • Attendance and participation in committee conference calls 

Please contact if you have any questions.

Special Study Deadline Extension

Thanks to everyone for your hard work on the special study. We have listened to your feedback about the study deadline and have decided to extend the deadline by four weeks. The new study deadline will be Wednesday, July 15.  We appreciate the dedication of those who have already submitted their cases. Thanks to their timeliness, we have been able to start looking at the data to help us understand post-treatment surveillance imaging patterns and recurrence in cancer patients across the country. Your help with this special study has the potential to inform guidelines for the post-treatment follow-up care of men and women diagnosed with cancer. 

Thank you for your time and all that you are doing to make this special study a success. Contact with any questions.

The CoC and NAPBC are Now Social

Connect with the CoC and the NAPBC on Twitter. The CoC Twitter Account (COC-ACS) has been open for almost two months and has nearly 150 followers. The NAPBC Twitter Account (NAPBC_ACS) account opened almost a year ago and has more than 675 followers. Following the success of the NAPBC Twitter account, our newest social media endeavor is Facebook. Be sure to like the NAPBC Facebook page. If you have suggestions on ways to enhance your social media efforts, please contact Susan Rubin

National Cancer Survivors Day

June 7 marks the 28th Annual National Cancer Survivors Day®, which brings cancer survivors together to show that there is life after receiving a diagnosis of cancer. 

The American College of Surgeons (ACS) Commission on Cancer (CoC) and the National Accreditation Program for Breast Centers (NAPBC) encourage your program to observe this day and use it as an opportunity to display or promote your CoC and NAPBC accreditation status. To help you promote this event within your program and the community, the CoC and the NAPBC have developed a poster that you can download and print. Programs that hold both CoC and NAPBC accreditations can access the poster by going to CoC Datalinks and clicking on Marketing Resources. For programs that are solely NAPBC-accredited, please use the link to the Marketing Resources website provided in your performance report email notification. 

The CoC and the NAPBC encourage you to reach out to your community and sponsor activities that:

  • Recognize cancer survivors 
  • Support patients with cancer 
  • Screen and educate community members on cancer prevention and detection 

Additional resources to promote your event are available on the National Cancer Survivors Day website. Please let us know about your celebration by sending photos and event information to Susan Rubin, Business Development Manager, ACS Cancer Programs.

Advocacy Update

Join Us for OVAC Lobby Days to Encourage Cancer Research Funding

One Voice Against Cancer is sponsoring Lobby Days, June 8-9, at the Hilton Crystal City at Reagan National Airport, Washington, DC.  This is your chance to be in your legislator’s office to discuss the importance of adequate funding for cancer care and research. Registration fees are $125 and hotel rooms may be booked through the registration website. The cost is $179 per night plus taxes. The room block and negotiated room rate cannot be guaranteed.

Register for Lobby Days

The CoC Advocacy Committee is sponsoring a legislative briefing, Accreditation Makes a Difference, 12:30-1:30 pm, June 9, in room B340 of the Rayburn House Office Building, Washington, DC. 

The CoC anticipates the introduction of a Congressional Resolution recognizing the importance of accreditation by the ACS CoC in ensuring patient access to high-quality, comprehensive cancer care. 

Accreditation Corner

NCI-Designated Cancer Programs No Longer Exempt from Standard 2.4 Palliative Care

Following the recent CoC Spring Meetings held on May 7th and 8th, the Accreditation Committee approved a motion to remove the current Standard exemption for all CoC-accredited National Cancer Institute (NCI)-Designated Comprehensive Cancer Programs (NCIPs).

Beginning on January 1, 2016, all NCIPs will be required to meet compliance criteria (as outlined below) for Palliative Care, Standard 2.4. This change will be published in the next version of the Cancer Program Standards: Ensuring Patient-Centered Care manual. NCIPs surveyed in 2016 will not be rated on this standard but will be evaluated for compliance in 2017.

Standard 2.4

Palliative Care Services: Palliative care services are available to patients either on-site or by referral.


A multidisciplinary team of physicians, nurses, mental health professionals, social workers, and spiritual counselors provide palliative care services. The cancer committee will define on-site and off-site services. This definition will be reviewed by the cancer committee annually. A member of the palliative care team is a required member of the cancer committee when these services are provided at the facility. 

Types of palliative care services include:

  • Team-based care planning that involves the patient and family
  • Pain and non-pain symptom management
  • Communication among patients, families, and provider team
  • Continuity of care across a range of clinical settings and services
  • Attention to spiritual comfort
  • Psychosocial support for patients and families
  • Bereavement support for families and care team members 
  • Hospice care

Palliative care services on site will vary depending on the scope of the program, local staff expertise, and patient population. Palliative care services not provided on site at the facility are provided through formal referral to other facilities and/or local agencies. 


  • The program completes all required standard fields in the Survey Application Record (SAR). 
  • The program uploads the policies or procedures for providing palliative care on-site or by referral.

For questions about CoC Standards, please utilize and submit questions to the CAnswer Forum

For questions regarding the Survey Application Record/Program Activity Record (SAR/PAR) and how to document standard compliance, please e-mail

Continuously Update Your PAR in CoC Datalinks

Cancer program staff should continuously and concurrently update cancer program activity within CoC Datalinks throughout the accreditation cycle. Waiting until right before a survey to complete SAR fields and upload documentation from the past three years will lead to a rushed job and unneeded stress!

In addition, there are notable areas within CoC Datalinks and the SAR/PAR that should be reviewed and updated annually, including:

1) Facility and Staff Contact Information

  • Update contact information for current cancer program staff; add new contacts, review, and delete outdated information. We pull this information directly from CoC Datalinks when sending communications and accreditation fee invoices. 

2) Eligibility Requirements (ER) in CoC Datalinks

  • Upload policies and procedures or other documentation (delete previous versions) that have been revised during the last 12-month period for all ERs.

3) Review and update the resources and care services provided by your facility.  

  • Many of the ERs have checkboxes to indicate your on-site or referral services. This information is displayed in the CoC Hospital Locator for the public to see, so it must be accurate! 

 4) Standards 5.5 and 5.6

  • It is recommended that you annually review compliance with Standards 5.5 and 5.6 (National Cancer Data Base [NCDB] Annual Call for Data submissions) and address any questions or issues directly with NCDB staff at, and not wait until after the survey.

Completion of the SAR/PAR is a cancer committee team effort and not solely the responsibility of the registry staff. We suggest having each designated coordinator complete the standard that falls under their purview, and projecting the information periodically to the entire cancer committee so that every user, whether registered or not, is familiar with the look of the CoC Datalinks.

2015 SURVEYS REMINDER: Prior to a cancer program’s survey, the SAR is to be completed 30 calendar days before the confirmed survey date enabling the surveyor to begin a prereview and contact you if necessary. Fourteen (14) calendar days before the survey date, the SAR will officially be locked for edits by the programs. The Accession List link (located on the SAR menu) and the table in Standard 2.1 (pathology report review) will remain open during these two weeks.

Helpful Hints

If you are unable to save your entry or document is not saving, make sure all fields in the table are completed, the document is not over 20 megabytes, and that you have selected cancer committee dates from the date fields (as completed in Standard 1.3). CoC Datalinks works best with Mozilla FireFox or Internet Explorer Version 9 or higher. 

Other helpful features available in the SAR/PAR:

  • Help and FAQ icons, which contain information on each standard
  • Electronic submission of Appeals and Deficiency Resolutions 
  • Printing capabilities of the SAR/PAR 

CoC News Items

If you are having any difficulties or questions about the SAR/PAR, please e-mail Please remember to include your facility name, FIN, standard number, and the specific field/table that is causing an issue.

Outstanding Achievement Awards Granted and Announced Biannually

In response to a recent decision by the Accreditation Committee, cancer programs that earn the CoC Outstanding Achievement Award (OAA) based on the required commendation criteria will be notified twice a year beginning in July 2015. Previously, OAA notifications went out after all accreditation surveys had taken place in a calendar year.

Programs eligible for the OAA and surveyed January 1–June 30, 2015, will be announced late summer.  Eligible programs surveyed July 1–December 31, 2015, will be announced in early 2016. 

The CoC OAA acknowledges cancer programs that achieve excellence in providing quality care to cancer patients and demonstrate a commendation level of compliance with seven standards during their accreditation survey.

Complete information regarding marketing materials and the OAA trophy will be e-mailed directly to OAA recipients. 

Resources for Cancer Liaison Physicians

Are You Being Surveyed?

The CLP is expected to be present during the CoC survey, and available to meet one-on-one with the surveyor. As the CLP, you can expect that during this confidential meeting, the surveyor will be supportive of the challenges and opportunities that you face in your efforts to evaluate and improve the quality of care in your cancer program.

CLP Activity Report

As the CLP, one of your tasks is to complete the CLP activity report. This report is found in CoC Datalinks and is part of your Survey Application Record (SAR). Not only is it important to complete this report during the time of your program’s scheduled survey, your responses are used to make program improvements, to gauge your work in the field, and to inform the surveyor of your activities. Be sure to familiarize yourself with this report and complete it on an annual basis.

80% by 2018 Initiative - Take Action Now

The Commission on Cancer, a Quality Program of the American College of Surgeons, is a member of the National Colorectal Cancer Roundtable (NCCRT), established in 1997 by the American Cancer Society and the Centers for Disease Control and Prevention.  The NCCRT is a national coalition of organizations and individuals dedicated to eliminating colorectal cancer as a major public health problem.  The NCCRT has embarked on 80% by 2018, an initiative to increase colorectal cancer screening rates in the U.S. from the current rate of 65% to 80% by 2018.  

The NCCRT is committed to work toward increasing the number of people screened for colorectal cancer. By working together, demanding more of ourselves, and collectively pushing harder, we will make greater progress, prevent more cancers, and save more lives.

The NCCRT has multimedia resources available to guide you when making a presentation or leading or participating in a colorectal screening initiative.  

If you have not already watched the 80% by 2018 video recorded by Daniel P. McKellar, MD, FACS, Commission on Cancer Chair, and Richard C. Wender, MD, American Cancer Society’s Chief Cancer Control Officer, this is an important message and well worth 15 minutes of your time or showing at your next cancer committee meeting.  

Take the first step and find out what the colorectal cancer screening rates are in your state and bring cancer programs and primary care providers together to join this initiative.

Remember, colon cancer is the third-leading cause of cancer deaths in the U.S. and the second-leading cause when combining men and women, yet it can be prevented or detected at an early stage with evidence-based screening tests.  

New State Chair

The CoC welcomes a new State Chair:

Michael Walker, MD, FACS 

Metropolitan Philadelphia 

Educational Programs and Resources

Register Today to Attend Survey Savvy

Register Now for Survey Savvy! 

Survey Savvy 

June 18-19, 2015

Survey Savvy, provides in-depth review of the information your cancer committee needs to coordinate a high-quality, patient-centered, multidisciplinary cancer program. Developed by CoC staff and CoC committee leadership, this program addresses your cancer programs' most common questions, issues, and concerns regarding CoC standards and compliance. 

Whether your cancer program is preparing for a re-accreditation survey or looking for clarification on the standards, this program provides increased understanding of standard requirements and implementation. Through lectures, panel presentations, and the opportunity to meet and speak with experts, cancer program members will learn how to use the CoC standards as a framework to develop a comprehensive cancer care program that delivers high-quality and patient-centered care. 


$850 after May 15

Visit the Survey Savvy web page for further meeting information, hotel information, and to register. Space is limited.


Please share this information with other members of your staff who would benefit from the information that is being presented. Team attendance is encouraged for this conference.

Plan to Attend the Next Accreditation 101

Accreditation 101: Learning the Basics of CoC Accreditation and Standards

Friday, September 11

Baltimore, MD

  • Are you a new staff member just learning about Commission on Cancer (CoC) accreditation?
  • Is your cancer program considering CoC accreditation, and you want to learn about the CoC Standards?
  • Do you want a refresher on the CoC accreditation process and standards?

If you answered yes to any of these questions, then Accreditation 101: Learning the Basics of CoC Accreditation and Standards is for you.

Registration is set to open in mid-June and will be announced in the CoC Source and CoC Brief. Stay tuned to the CoC Meetings page for further meeting and hotel information and to register. Space is limited.

This is the only program developed and taught by CoC surveyors and staff that reviews the CoC Standards, provides practical information on how to achieve compliance, and discusses the important role you and your cancer team play throughout the continuum of cancer care. Get the information you need from the people involved in standard development and the survey process.

Registration Fee

$750 on or before July 31

$850 after July 31

This fee includes a copy of the Cancer Program Standards 2012: Ensuring Patient-Centered Care v1.2.1, ($50.00 value), resource materials, breakfast, lunch, and breaks.

Please share this information with other members of your staff who would benefit from the information that is being presented.

Continuing education credit will not be offered for this program. 

News from ACoS Cancer Programs


AJCC Registrar Curriculum – Module III Lessons Now Available 

The American Joint Committee on Cancer (AJCC) Curriculum for Registrars, launched in January 2015, provides education in a step-wise learning environment complete with additional resources to reinforce the information and webinars with interactive quizzes to prompt discussion and serve as a self-assessment for the information learned. This is adult self-guided learning, and you are expected to review the lessons before attending the live or recorded webinars.

We are excited to announce that two continuing education (CE) hours each are being offered for the remaining modules II–IV. The Module II recording is now available for you to access. 

The Module III lessons are now available and the webinar will be held June 23. Mark your calendar and go to the AJCC site to register to attend live! There is a limit of 1,000 spots for the live webinar. If you are not able to participate, you can still get CE credit for the recorded webinar. We understand that some people can't participate in the webinar during the day, and so we encourage you to view the recording that is now available for Modules I and II. The recording of the Module III webinar should be available 48 hours after the live broadcast. 

Please remember to use the CAnswer Forum for questions related to the webinars.

Improving the Quality of Cancer Staging

“Improving the Quality of Cancer Staging” has been published in CA: A Cancer Journal for Clinicians by Elliot Asare, MD, the AJCC Clinical Scholar in Residence, Mary Kay Washington, MD, PhD, Donna Gress, RHIT, CTR, Jeffrey Gershenwald, MD, and Frederick Greene, MD.

The article discusses the critical need for quality staging in light of the Institute of Medicine’s call for adherence to quality indicators and measures, along with the need to assess treatment and outcomes based on staging.  The registrar’s role in staging is highlighted.

The article can be accessed at

News from the Oncology Community


NCRA Releases New Cancer Case Studies Workbook

NCRA’s Cancer Case Studies Workbook provides opportunities for registrars to practice assigning AJCC TNM Stage and coding SEER Summary Stage. The book has been designed to assist those new to the cancer registry field to build their skills as well as seasoned professionals who want to improve their proficiencies. The 40 cases were prepared by Donna Gress, RHIT, CTR. Answers and rationales provided. Member price: $75; Non-member price: $95. Order at

Get Ready for the Transition from CS to AJCC TNM Stage and SEER Summary Stage with NCRA’s Special Subscription

NCRA is offering a special TNM and Summary Stage subscription to its Center for Cancer Registry Education. For $119, members can access all of NCRA's recent training on how to assign AJCC TNM Stage and code SEER Summary Stage, including over 15 learning modules. Related sessions from the 2015 Annual Conference will also be included. Offer ends June 30, 2015. Go to to order.

NCRA Announces Two Live Webinars on AJCC TNM Stage: Breast and Bladder 

NCRA will present two new site-specific webinars to round out its TNM and Summary Stage training that began in the fall of 2014. The two concluding webinars will provide the essential information for using the correct classification and assigning all of the AJCC TNM stage elements for the breast and bladder. Andrea Spaulding, RN, CTR, will present the Assigning AJCC TNM Stage: Breast webinar on June 10. Jayne Holubowsky, CTR, will present the Assigning AJCC TNM Stage: Bladder on June 24. Both webinars are at 2:00 p.m. ET. Earn one CE for each. Register at

New Cancer Surgery Manual Available from the American College of Surgeons and Alliance for Clinical Trials in Oncology

The American College of Surgeons and the Alliance for Clinical Trials in Oncology present the first comprehensive, evidence-based examination of cancer surgery techniques that are critical to achieve optimal outcomes in a cancer operation. Operative Standards for Cancer Surgery, published in June by Wolters Kluwer, is a unique manual that focuses on best practices for breast, colon, lung, and pancreatic surgery, describing the surgical procedures that occur between skin incision and skin closure that directly affect cancer outcomes. The effort to develop a manual that details the critical elements of cancer surgery was first envisioned by Heidi Nelson, MD, FACS, Fred C. Andersen Professor and vice-chair, research, department of surgery, Mayo Clinic, Rochester, MN, and the resulting textbook has been the main focus of the activities of the Cancer Care Standards Development Committee, led by Kelly Hunt, MD, FACS. Dr. Hunt is professor, department of surgical oncology, division of surgery, and chief, breast surgical oncology section, department of surgical oncology, University of Texas MD Anderson Cancer Center, Houston, for the past three years. 

The manual provides recommendations based on the strongest available evidence on the proper conduct of operations and detailed information on the oncologic principles, avoidable pitfalls, and the quality of the evidence for these recommendations. Since randomized trials have not addressed all of the components of operations within each disease site, Operative Standards draws on the experience and consensus opinion of the experts writing the individual chapters. Identifying the lack of evidence on certain topics has been an unintended consequence of writing this manual and has galvanized the authors to establish standards where none currently exist. With the participation of more than 120 surgeons in this first edition, this is the best resource currently available on the proper conduct of an operation for cancer of the breast, colon, lung, and pancreas. 

Within each disease site, several operative procedures were chosen that were considered common but important to describe. The manual is not a surgical atlas; rather, the emphasis is on oncologic fundamentals and critical elements in the conduct of the operation and intraoperative decision making. In addition, the participants identified areas of controversy and posed several key questions that were then analyzed with a systematic review of current literature. These questions might serve as the basis for a new clinical trial within each disease site. Each disease group was composed of a leadership committee consisting of a section editor, a methodologist, and an art/illustrations editor. Surgeons with expertise in each disease site were recruited from all of the national societies and cooperative groups to include broad representation. International experts were also invited to participate in each section. Much of the initial work was done by conference calls followed by collaborative writing over one-and-a-half years. This work culminated into a textbook, which will also be available as an online resource. 

Because we anticipate continued evolution in surgical oncology, these initial four disease site sections will be updated every two to three years. Planning is already underway for the second edition of this manual, which will include procedures in melanoma, gastric cancer, esophageal cancer, rectal cancer and thyroid cancer. 

Operative Standards for Cancer Surgery is available for download. Purchasers of the print edition will also receive the bundled interactive ebook edition, offering tablet, smartphone, or online access.

New Website Helps Educate Patients on the Value of Clinical Trials

About Clinical Trials (ACT) is a unique, on-line resource that features unscripted interviews with clinical trial participants, physicians, patient rights advocates, and others. The stories and information presented should be shared with your patients in order to have educated discussions on the importance of clinical trials. The videos include: Why Should I Consider a Cancer Clinical Trial?,  How Will I Know if a Clinical Trial is Right for Me?, How Should I Prepare for Discussions with My Doctor?,  What Standards are in Place to Safeguard Trial Participants?, What is Informed Consent?, and Where Can I Turn for Information and Support?   

Presenters in this series include: Otis Brawley, MD, FACP (Oncologist), Arthur Caplan, PhD (Medical Ethicist), Constance Dennis-Bragg and Shelley Snider (Study Participant and Caregiver), Rose and Robert Gerber (Study Participant and Caregiver), Sandra Horning, MD (Oncologist), Susan Love, MD (Surgeon and Research Advocate), Dan McKellar, MD, FACS (Surgeon and American College of Surgeons Commission on Cancer Chair ), Joanna Morales, Esq (Cancer Rights Attorney ), Sandra M. Swain, MD, FACP (Breast Oncologist and Cancer Institute Medical Director), and Jack and Jan Whelan (Study Participant and Caregiver).

Registration Now Open for the 2015 World Congress of Psycho-Oncology

Don’t miss your chance to participate and learn at this joint conference of the American Psychosocial Oncology Society (APOS) and the International Psycho-Oncology Society (IPOS). The 2015 World Congress of Psycho-Oncology, with the theme “From National to Global: Implementing the Standard of Psychosocial Care in Oncology,” promises to draw 600–800 psychologists, psychiatrists, nurses, social workers, clergy, and patient advocates from around the world, and is a unique opportunity to network and engage with psychosocial oncology clinicians, researchers, administrators, and advocates in one venue. During the conference, members of the international psycho-oncology community have the opportunity to share and learn about current science, global health initiatives, and new clinical interventions in the field of psychosocial oncology.

Through the 2015 World Congress of Psycho-Oncology, APOS and IPOS seek to engage local advocacy groups; directors of cancer centers’ psychosocial programs; medical, radiation, and surgical oncologists; and providers of psychosocial care for cancer patients across the lifespan. To this end, we have planned an exciting educational program that includes:

  • 20 half-, one-, and two-day workshop academies prior to the three-day conference
  • Concurrent and plenary educational sessions featuring world-renowned invited speakers
  • High-quality scientific oral and poster presentations
  • Exhibits promoting the latest in cancer treatment choices, developments in supportive care and cancer education, and advocacy groups 
  • Special events, including a picturesque tour of Washington, DC, via a Potomac River dinner cruise, a private tour of the Washington Cathedral, and a theater performance by New York-based “Outside the Wire” theater company.