Introduction to Cancer Treatment

Cancer treatment involves medical procedures to destroy, modify, control, or remove primary, nodal, 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 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. This 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
• make the patient comfortable
• Improve quality of life

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 or palliative care.

To ensure complete and accurate treatment data, cancer registrars should be familiar with the terms "first course of treatment" and "treatment for recurrence or progression" and be familiar with the differences between the two periods of treatment.

First course of treatment includes all methods of treatment recorded in the treatment plan and administered to the patient before disease progression or recurrence. First course treatment may include different modalities and span a year or longer. For leukemias any treatment received after a relapse is considered subsequent treatment. In a cancer registry abstract, 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.

Current SEER Treatment coding guidelines can be found in the SEER Program Coding and Staging Manual and will be a useful reference while reviewing this section of the training website.

Updated: December 21, 2023