California Cancer Registry Volume I: Abstracting and Coding Procedures for Hospitals
This page was created to capture terms and definitions often used in abstracting.
Active Surveillance: A treatment plan that involves closely watching a patient’s condition but not giving any treatment unless there are changes in test results that show the condition is getting worse. Active surveillance may be used to avoid or delay the need for treatments such as radiation therapy or surgery, which can cause side effects or other problems. During active surveillance, certain exams and tests are done on a regular schedule. It may be used in the treatment of certain types of cancer, such as prostate cancer, urethral cancer, and intraocular (eye) melanoma. It is a type of expectant management.
Antineoplastic Drugs: Applies to medications that prevent the development, maturation, or spread of cancer cells. Included are drugs for chemotherapy (see Section VI.4), hormonal treatment (see Section VI.5), and immunotherapy (see Section VI.6). For cases diagnosed 1/1/2005 forward, registrars must use SEER*Rx, for coding systemic treatment (i.e. chemotherapy, hormone therapy, and immunotherapy). SEER*Rx is the downloadable, interactive antineoplastic drug database that replaces SEER Self-Instructional Manual Book 8, Antineoplastic Drugs. The software can be downloaded from the SEER*Rx Web Site.
Bone Marrow Transplant (BMT) Allogeneic: Receiving bone marrow or stem cells from a donor; including haploidentical (or half-matched) transplants.
Cancer Tissue: Proliferating malignant cells or an area of active production of malignant cells. Sometimes malignant cells are found in tissue in which they did not originate and are not reproducing. A procedure that removes cancer cells but does not attack a site of proliferation of the cells (thoracentesis, for example) is not considered cancer treatment.
Chemoembolization: A procedure in which the blood supply to the tumor is blocked surgically or mechanically and anticancer drugs are administered directly into the tumor. This permits a higher concentration of drug to be in contact with the tumor for a longer period of time.
Consolidation Chemotherapy: Repetitive cycles of chemotherapy given immediately after the remission.
Definitive Cancer Treatment: Therapy that normally modifies, controls, removes, or destroys proliferating tumor tissue, whether primary or metastatic, even if it cannot be considered curative for a particular patient in view of the extent of disease, incompleteness of treatment, apparent lack of response, size of the dose administered, mortality during surgery, or other reason. The term excludes therapy that has no effect on malignant tissue. Procedures administered for the sole purpose of relieving symptoms are therefore not considered to be cancer treatment.
Deferred Therapy: Closely watching a patient’s condition but not giving treatment unless symptoms appear or change, or there are changes in test results. Deferred therapy avoids problems that may be caused by treatments such as radiation or surgery. It is used to find early signs that the condition is getting worse. During deferred therapy, patients may be given certain exams and tests. It is sometimes used in prostate cancer. Synonym: expectant management.
Direct Extension: A continuous infiltration or growth from the primary site into other tissue or organs (compare to metastasis).
Disease Recurrence: For solid tumors, see the Multiple Primary and Histology Coding Rules manual and for hematopoietic and lymphoid neoplasm see the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding manual and the Hematopoietic Database to determine disease recurrence.
Expectant Management: Closely watching a patient’s condition but not giving treatment unless symptoms appear or change, or there are changes in test results. Expectant management avoids problems that may be caused by treatments such as radiation or surgery. It is used to find early signs that the condition is getting worse. During expectant management, patients may be given certain exams and tests. It is sometimes used in prostate cancer. Synonym: deferred therapy.
Induction Chemotherapy: Initial intensive course of chemotherapy.
Invasion: Local spread of a neoplasm by infiltration into or destruction of adjacent tissue.
Maintenance Chemotherapy: Chemotherapy given for a period of month or years to MAINTAIN REMISSION.
Metastasis: The dissemination of tumor cells from the primary site to a remote part of the body. It is important to distinguish metastatic lesions from new primaries. A metastatic lesion is not a primary tumor. Pathologic reports are usually the best source. The term "secondary" is sometimes used for a metastatic lesion. Since the lymphatic system is one of the main routes of metastasis, frequent reference will be found in examinations of the lymph nodes. Occurrence of a lesion in a lymph node ordinarily indicates metastasis.
Microinvasion: The earliest stage of invasion—as malignant, not “in-situ”.
Microinvasive: The earliest invasive stage. Applied to cervical cancer, describes a small cancer that has invaded the stroma to a limited extent. The FIGO stage is IA.
Palliative: Ordinarily means (1) non-curative, or (2) alleviation of symptoms. If used for a procedure that is directed toward symptoms only, the therapy is not considered to be treatment (Examples: colostomy, removal of fluid—even if cancer cells are present—to ease pressure, neurosurgery to relieve pain).
Radioembolization: Tumor embolization combined with injection of small radioactive beads or coils into an organ or tumor.
Regional: Organs or tissues related to a site by physical proximity. Also applies to the first chain of lymph nodes draining the area of the site.
Remission: The bone marrow shows normal cellular characteristics (is normocellular), with less than 5% blasts, no signs or symptoms of the disease, no signs or symptoms of central nervous system leukemia or other extramedullary infiltration, and all of the following laboratory values within normal limits: white blood cell count and differential, hematocrit/hemoglobin level, and platelet count.
Treatment Failure: The treatment modalities did not destroy or modify the cancer cells. The tumor either became larger (disease progression) or stayed the same size after treatment.
Tumor Embolization: The intentional blockage of an artery or vein to stop the flow of blood through the desired vessel.
Watchful Waiting: Closely watching a patient’s condition but not giving treatment unless symptoms appear or change. Watchful waiting is sometimes used in conditions that progress slowly. It is also used when the risks of treatment are greater than the possible benefits. During watchful waiting, patients may be given certain tests and exams. Watchful waiting is sometimes used in prostate cancer. It is a type of expectant management.