Cancer Treatment

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.