After much fiscal analysis and soul-searching by
myself and many of April’s’ long-time registry colleagues,
we have reluctantly determined that is impossible to keep
A.Fritz and Associates operating without her.
It was always April’s intention
to keep her books and classes at a reasonable and affordable
price. We never charged the company for the time she and I
put into her projects. She never operated this as a “for
profit” enterprise. If it cost more to put on a class than
the money we collected in fees, she was OK with that. But
at the end of the year, we always came out a little ahead
and that was fine with us. She considered her books and
classes to be a service to improve the quality of cancer
In order to continue to update her classes and
teach them on a regular basis, I would have to hire expert
registrars to write and present the material. To fairly
compensate these registrars, I would need to increase our
prices significantly. That would put our products out of
reach for those students who to pay for training out of
pocket. April’s colleagues report that there are a number
of other quality learning opportunities being offered by
other organizations/associations; many of these were
unavailable when April started the company 12 years ago.
Especially hard for me is the decision to not
publish the 3rd Edition of the Cancer Registry
CASEbook. April was developing updates during the last two
years of her life while going through chemo. However, the
final 2018 updates by the standard setters were slow in
coming—and, in fact, some are still not available.
Informal surveys were conducted at several state
association meetings. They revealed that the CASEbook
itself is not needed as much as the ability to incorporate
the expertise of the CASEbook into the material of newly
updated training websites. The CASEbook incorporated
valuable detail that should not be lost.
Several years ago, when registrars abstracted,
they needed multiple standards reference books (ICD-O,
FORDS, Collaborative Stage, Summary Stage, Multiple Primary,
site-specific items, etc.) simultaneously open on their
desk. Most references are now electronically available, and
it is much easier to toggle between windows on a computer
than between open books on a desk.
Also, changes in standards are no longer released
in batches every few years. Today electronic updates are
introduced continuously, making it impractical to rely on
printed books. And finally, keeping materials current would
require an increase in the price of the books—something that
April and I were determined shouldn’t happen.
Unfortunately, an honest cost/benefit analysis of the
CASEbook 3rd Edition has doomed it.
I really wish I could keep April's legacy alive by
continuing her work, but for the reasons I have stated, I
cannot. However, I think--and believe--that her legacy will
be helping create a better trained cohort of registrars than
the one she joined more than 40 years ago and who are
continuing to contribute to the battle against the very
disease that took her from us.
Chief Operating Officer