Division Co-Chiefs: Harry Harper
Quality Indicators
(Medical/Surgical/Radiation):
- All patients are properly staged. (Medical)
- Length of stay, mortality, morbidity, and cost are monitored for surgical patients. (Surgical)
- Core biopsy is performed when feasible as opposed to FNA. (Surgical)
- Radiation patients (combined modality) receive a nutrition consult/screening at the start of and during treatment for esophageal and lung cancer patients. (Radiation)
- Smoking cessation is discussed and encouraged to patients who smoke.
All Patients
- All patients with solid tumors are staged according to ACoS standards.
- All patients who are receiving chemotherapy have a plan documented prior to administration of therapy.
Diagnostic Work Up:
Small Cell Lung Cancer
| ICD 9 Codes |
| 162.0 |
| 162.2 |
| 162.3 |
| 162.4 |
| 162.5 |
| 162.8 |
| 162.9 |
| 165.0 |
| 165.8 |
| 165.9 |
| 194.6 |
| 194.8 |
| 194.9 |
| 195.1 |
| 209.21 |
| 209.25 |
| 231.1 |
| 231.2 |
| 231.8 |
| 231.9 |
| 235.7 |
| 235.8 |
| 235.9 |
| 239.1 |
|
| Diagnostic Work Up |
| Test/Exam: |
History & Physical Examination |
CBC |
Chemistry profile |
CT Chest & Abdomen with contrast |
MRI Brain with and without gadolinium |
Bone scan |
PET scan whole body (optional) |
Fine needle aspirate (FNA) and/or core needle biopsy |
Tissue diagnosis with histology and cytology review |
Smoking cessation counseling if applicable |
Limited Stage: |
Exam/Test |
Unilateral marrow aspiration/biopsy |
Thoracentesis if pleural effusion seen in chest x-ray |
Pulmonary Function Tests if indicated |
Bone radiographs of abnormal uptake seen on bone scan |
MRI of bony lesions if x-rays are negative or inconclusive |
Extensive Stage: |
Exam/Test |
X-rays of bone scan abnormalities of weight-bearing areas. |
|
| Prognostic Work Up |
Cigarette smoking |
Environmental exposures |
Genetic factors/Family history |
Weight loss |
Debility |
Bone pain |
Neurologic Compromise |
Performance status |
Stage |
Gender |
Age |
Cancer markers |
|
Non-Small Cell Lung Cancer
| ICD 9 Codes |
| 162.0 |
| 162.2 |
| 162.3 |
| 162.4 |
| 162.5 |
| 162.8 |
| 162.9 |
| 165.0 |
| 165.8 |
| 165.9 |
| 194.6 |
| 194.8 |
| 194.9 |
| 195.1 |
| 209.21 |
| 209.25 |
| 231.1 |
| 231.2 |
| 231.8 |
| 231.9 |
| 235.7 |
| 235.8 |
| 235.9 |
| 239.1 |
|
| Diagnostic Work Up |
| Test/Exam: |
History & Physical Examination |
CBC |
Chemistry profile |
CT Chest & Abdomen with contrast |
PET scan whole body |
Bone Scan if signs or symptoms of bone metastases |
MRI Brain with and without gadolinium if surgical candidate or signs and symptoms of brain metastases |
Fine needle aspirate (FNA) and/or core needle biopsy |
Tissue diagnosis with histology and cytology review |
Smoking cessation counseling if applicable |
|
| Prognostic Work Up |
Stage |
Performance Status |
|
Cancer of the Thymus
| ICD 9 Codes |
| 164.0 |
| 164.1 |
| 164.2 |
| 164.3 |
| 164.8 |
| 164.9 |
| 165.0 |
| 165.8 |
| 165.9 |
| 194.6 |
| 194.8 |
| 194.9 |
| 209.22 |
| 230.8 |
| 230.9 |
| 235.8 |
| 235.9 |
| 239.1 |
|
| Diagnostic Work Up |
| Test/Exam: |
History & Physical Examination |
CBC |
TSH (Thyrotropin), T3 & T4 levels are optional |
Serum beta-HCG & Alpha-Fetoprotein |
CT Chest with contrast |
PET scan whole body is optional |
Radiolabeled octreotide scan is optional |
|
|
