Cancer treatment involves medical procedures to destroy, modify,
control, or remove primary, regional, or metastatic cancer tissue.
The goals of cancer treatment include eradicating known tumors
entirely, preventing the recurrence or spread of the primary
cancer, and relieving symptoms if all reasonable curative approaches
have been exhausted.
Decisions concerning how to treat a particular cancer are
based on many factors. The primary goal is to choose an approach
that will remove the tumor, rid the body of wandering cancer
cells, and prevent a recurrence.
For cancer registrars, it is necessary to distinguish cancer-directed
treatment from non-cancer directed treatment, which are recorded
differently in cancer data fields.
Any treatment that is given to modify, control, remove or
destroy primary or metastatic cancer tissue is cancer directed
treatment. The type of treatment is meant to remove a tumor
or minimize the size of tumor or delay the spread of disease.
Non-cancer directed treatment refers to any treatment designed
to prepare the patient for cancer-directed treatment, prolong
a patient's life, alleviate pain, or make the patient comfortable.
Non-cancer directed treatments are not meant to destroy the
tumor, control the tumor, or delay the spread of disease.
These treatments include diagnostic tests and supportive care.
To ensure complete and accurate treatment data, terms such
as "first course of treatment" and "treatment for recurrence
or progression" should be defined.
First course of treatment includes all methods of treatment
recorded in the treatment plan and administered to the patient
before disease progression or recurrence. In cancer treatment
data registration, the date of the first course treatment
is the month, day, and year of the first cancer-directed treatment
that is administered.
Treatment of recurrence or progression (also called "subsequent
treatment") includes all cancer-directed treatments administered
after the first course of treatment is completed, stopped,
or changed. For the date of "Subsequent Treatment(s) For Recurrence
or Progression," the date(s) of treatment(s) administered
for progression or recurrence of disease is(are) recorded.
In short, subsequent treatment starts after the first course
of treatment has been completed, stopped, or changed.
This learning module provides brief discussions of the common
cancer treatment approaches and how the treatment information
should be used and coded by a cancer registrar. Cancer registrars
will need the SEER Program Code Manual, Third Edition (NIH
Publication No. 98-2313) and the CoC's ROADS Manual for the
definitions and standard codes to be used in the treatment
data fields.
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