YOKOSUKA NAVAL BASE, Japan — Acture, a tumor registry system, has been around for decades but is just as valuable as the latest high-tech medical systems.
Physicians at Yokosuka Naval Hospital use the national database and supply it with specific data about individual patients, the type of cancer they have and how it has been treated, said Lt. Cmdr. Brian Schnell, director of the program there.
“This is especially valuable for people in the military,” he said. Such people transfer often, and seeing a series of doctors for a few years each is not uncommon. With the registry, Schnell said, doctors at the patient’s next duty station can access particular information about his or her tumors “and what kind of treatment has been used,” he said.
Doctors at Yokosuka Naval Hospital see about 40 patients with malignant tumors each year, he said. The hospital sees patients from branch clinics at Misawa Air Base, Atsugi Naval Air Facility, Iwakuni Marine Corps Air Station, Sasebo Naval Base and Okinawa.
“It’s a rather large area, and although 40 doesn’t seem like a very large number, you have to remember that most of the patients we see fit a certain younger demographic. Many cancerous tumors tend to appear in older people. We simply don’t see a lot of patients here in [their] 70s and 80s,” he said.
Typically seen among Yokosuka patients are melanoma or skin cancers, testicular tumors and reproductive-system tumors in women, the doctor said.
Although individual patient information is stored in the computerized registry, “this is privileged information that is protected, just like your medical records. It’s not just free-floating out there,” Schnell said.
Almost all hospitals except those that are very small participate, he added.
“In every participating hospital, you take information that’s relevant to the patient and add it to the databank. Basically, you have fields that you fill in with identifying information,” he said.
“You indicate the characteristics of the malignancy, what organ it was located in, what the pathologist had to say about it, how far it had progressed, were any additional operations required and did it spread to lymph nodes.”
“We’re still learning about cancer, and the best way to learn is to watch how people react” to treatment, he added.
Acture helps compare cancers because every tumor behaves differently depending on size and location. Doctors use the program to view and develop statistics on which medicines work and how people, as well as tumors, respond to those medicines.
“A diagnosis of Hodgkin’s disease used to be a death sentence,” Schnell explained in a recent Naval hospital report. Hodgkin’s disease is a lymphatic disease that affects the immune system and kills 1,300 Americans each year. “Now,” said Schnell, “it is very treatable.”
He said Acture, which does not store information on benign tumors, most definitely contributes to saving lives.
“It has certainly contributed; as well, it is providing valuable information for those involved in cancer research,” he said. Over time, researchers begin to see how particular cancers respond to specific treatments in general.
Schnell said his assistant, Kanako Shino, most deserves kudos for maintaining the system in Yokosuka.
“All information on patients is collected using pharmacy, radiology, inpatient and outpatient records,” explained Shino, a Japanese master labor contractor specially trained to use the system.
After reviewing records, she answers database questions to identify the type of tumor.
“It’s a lot of work,” she said in the report. “But it’s a very good system, and it really helps.”
She’s meticulous in entering the information, Schnell added.
“When we enter information into Acture, then people in the United States can see it, too,” he said. “Like if we forward a patient to Hawaii, they can look at Acture and find out what’s going on with the patient.”
Schell left Yokosuka last week for his next assignment at National Naval Medical Center Bethesda, Md.
Lt. Cmdr. Lori Rogers and Lt. Cmdr. David Burch, both Navy physicians, will assume Schnell’s duties pertaining to Acture.