Becker’s Healthcare Podcast: Dr. Frederick L. Greene – Cancer Data, Staging, and Leadership in Oncology

Release Date: January 20, 2026
Guest: Dr. Frederick L. Greene, Emeritus Chair of Surgery at Carolinas Medical Center, Medical Director of Cancer Data Services at Atrium Health-Levine Cancer Institute
Host: Scott Becker

Episode Overview

This episode features Dr. Frederick L. (Rick) Greene, a pioneering surgical oncologist and national leader in cancer data and staging systems. Dr. Greene shares insights from his decades-long career—from shaping cancer staging worldwide to advancing cancer data services and mentoring future leaders in medicine. The conversation centers on the evolution of cancer treatment, the critical role of accurate data and staging, and the importance of lifelong learning, accreditation, and prevention in healthcare.

Key Discussion Points & Insights

Dr. Greene’s Background and Current Focus (01:19)

• 28 years in Charlotte, NC: Former Chair of Surgery and Director of Surgical Residency at an academic medical center.
• Clinical interests: Surgical oncology—breast, pancreatic, and GI-tract cancers.
• Current role: Medical Director of Cancer Data Services, leading a team of oncology data specialists to collect and utilize patient data for research and advocacy.

  “All of the data that we use is used for research, it's used for advocacy, it's used for a number of issues. And it's just a pleasure to work with a wonderful group of professionals here.” (01:48)

The Evolving World of Cancer Treatment and Oncology (02:44)

• Major advances since 1976: Incorporation of advanced therapies, multidisciplinary approaches, and new technologies (e.g., proton therapy).
• Role in cancer staging: Led the global TNM (Tumor, Node, Metastasis) cancer staging system, fundamental to cancer care.
• Commission on Cancer: Past president; passionate about accreditation and ensuring institutions have the resources to care for cancer patients.

  “I've had the pleasure over the last 35 years of heading up the staging system that we use...We come out periodically with all of the new data.” (03:19)

• Progress in difficult cancers: Notable headway in areas like pancreatic cancer, though challenges remain.

Cancer Staging: Impact and Challenges (04:49)

• Staging is foundational: The stage determines prognosis and guides treatment, making accurate staging essential.
• Patient/family information needs: Patients often turn to the Internet, but risk misinformation.

  “You can't legislate the Internet...So one of the things we try to do is...create calculators that put the proper stage in patients.” (05:35)

• Efforts to provide accurate tools: Developing accurate, accessible calculators and guidelines for patients and clinicians.

History and Global Importance of the TNM System (07:16)

• Origins in the 1940s: Began with Dr. Pierre Denois in Paris on breast cancer staging.
• Evolution: Now the 9th edition; Dr. Greene has been involved since the late ’80s.

  “It was a surgeon who started this entire staging system...Now we're into the ninth version...but it started with a surgeon back in the 1940s and 50s.” (07:39)

The Balance of Uniformity and Personalization in Staging (08:30)

• From anatomy to molecular biology: Originally anatomical (tumor, node, metastasis), now incorporates biological and genetic markers.
• Personalized medicine: Key to improving outcomes as more markers are discovered and added.
• Global applicability: Anatomical staging remains vital, especially in low-resource settings.

  “The key to all of this is the genetic markers in cancer, and they will be added to many of these different sites in the future.” (09:51)

Current Trends: Data Quality, Registry, and Accreditation (10:04)

• Data accuracy matters: Accurate registry input is critical for research, policy, and patient care.
• Integration into state and national databases: Local data feeds into state registries and the National Cancer Database (American College of Surgeons).
• Accreditation: Ensures consistency and quality in cancer care, whether at small hospitals or major academic centers.

  “My point is that I think today accuracy is the key. You have to have accurate data put in, because if you don't, you won't know how these prognostic factors will work.” (10:53) “We want to make sure that [patients] get the same care...as going to an academic center...So accreditation is important and registry information is important.” (11:32)

Leadership, Mentorship, and Advice to Emerging Leaders (12:05)

• Mentorship: Advocates for opening doors and networking for young professionals.
• Pursuing passion: Importance of doing what you enjoy and never stopping learning.
• Lifelong relevance: Recommends striving to learn and contribute daily.

  “Make sure you learn something every day...for me in my career, we always want to be relevant. And that's why I love what I do.” (12:52)

The Essential Role of Prevention and Screening (14:41)

• Beyond treatment: Emphasizes prevention and early detection to reduce cancer burden.
• Physician’s duty: Encourages doctors to promote healthy living and regular screenings.
• Podcasting for awareness: Dr. Greene hosts three cancer-related podcasts focused on prevention and patient education.

  “Prevention and screening are so important in my work...and I try to make sure that my audience hears the message that I'm trying to give to them.” (15:23)

Notable Quotes & Memorable Moments

• On the Internet and patient information:

  “There are so many things in the Internet that are incorrect. You can't legislate the Internet.” – Dr. Greene (05:40)

• On the evolution of cancer staging:

  “I've had the pleasure over the last 35 years of heading up the staging system that we use...Well, I head up that system worldwide, and it's called the TNM system, the tumor node and metastasis system.” – Dr. Greene (03:17)

• On lifelong learning and relevance:

  “Make sure you learn something every day...for me in my career, we always want to be relevant.” – Dr. Greene (12:52)

Timestamps for Important Segments

• 01:19: Dr. Greene’s background and focus at Levine Cancer Institute
• 02:44: Evolution in cancer treatment and Dr. Greene’s involvement in cancer staging
• 03:19: Worldwide leadership in the TNM system and importance of multidisciplinary care
• 05:35: Challenges of patient self-education and Internet misinformation
• 07:16: History and development of the cancer staging system
• 08:30: Incorporation of molecular markers and genetic data in staging
• 10:20: Importance of data accuracy, quality review, and accreditation in cancer care
• 12:37: Advice to young leaders on learning, networking, and staying relevant
• 14:41: The necessity of cancer prevention and screening as part of clinical care

Tone and Style

Dr. Greene’s style is earnest, deeply experienced, and passionate about both the scientific and human sides of oncology. He emphasizes teamwork, the value of data, mentorship, and patient-centered communication, always maintaining a hopeful and resilient outlook. Host Scott Becker adopts a respectful, curious, and affirming tone throughout the conversation.

This summary provides a comprehensive guide to the content and major takeaways from Dr. Frederick Greene’s interview, offering value for listeners new to the episode and seasoned professionals alike.