This data item is to record cancer-directed treatments that cannot be appropriately assigned to the specific treatment codes in the cancer treatment data items for surgery, radiotherapy, systemic therapy agents and systemic therapy procedures.

Cancer-directed treatments refer to those treatments that destroy or modify cancer tissue anywhere in the body. The exception to this is treatments for hematopoietic diseases (refer to additional notes below).

Cancer-directed treatments may be palliative (to control symptoms, alleviate pain, or make the patient more comfortable) or curative.

Record all other treatments administered during the course of treatment.

Each treatment event delivered to the patient should be recorded; multiple entries are permitted.

Record antibody treatments, vaccine treatments, and those targeted therapies that use drugs or substances other than chemotherapy agents in this data item. Targeted therapies using chemotherapy agents are recorded in the data items for chemotherapy. Targeted therapies are treatments that use drugs or other substances to identify and attack specific cancer cells.

Do not record ancillary drugs. For example, allopurinol, which is commonly used as prophylaxis with chemotherapy agents to prevent severe hyperuricemia. A list of drugs regarded as ancillary is available in the SEER*Rx-Interactive Antineoplastic Drugs Database Version 1.4.1.

Treatment events may include (for example):

• Treatment unique to hematopoietic diseases, for example, phlebotomy, transfusions or aspirin. ONLY record aspirin therapy used to thin the blood for symptomatic control of thrombocythemia. Do not record aspirin used for pain or cardiovascular protection.
• Embolisation that is performed using alcohol as an embolising agent or for embolisation to a site other than the liver where the embolising agent is unknown. Embolisation using chemotherapeutic agents is coded separately with chemotherapy, and embolisation using a radioactive agent or seeds is coded with brachytherapy-radiation treatment.
• Any experimental or newly developed treatment that cannot be appropriately assigned to other specific treatment data items.
• A double-blind clinical trial. Record the treatment actually administered to the patient in the appropriate treatment data item when the double-blind trial code is broken.
• Cancer treatments administered by non-medical personnel. This includes unconventional methods whether administered as single therapy or in combination with conventional therapies. Record alternative therapies only if the patient doesn’t receive any other type of treatment.

American College of Surgeons 2002. Facility Oncology Registry Data Standards (FORDS), 2009 revision. Commission on Cancer

American College of Surgeons 1998. Standards of the Commission on Cancer: Registry Operations and Data Standards (ROADS), Volume II. Commission on Cancer