| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | initiation date | 0;1 | DATE-TIME | Record the date that subsequent therapy was initiated. | ||
| .02 | hema trans/endocrine proc | 0;18 | POINTER | 167 | Identifies systemic therapeutic procedures administered as part of subsequent course of treatment at this and all other facilities. If none of these procedures were administered, then this item records the reason they were not performed. These include bone marrow transplants, stem cell harvests, surgical and/or radiation endocrine therapy. For further information see FORDS pages 182-183. | |
| .021 | hema trans/endocrine proc date | 0;19 | DATE-TIME | Records the date on which hematologic transplant and endocrine procedures were performed. | ||
| .03 | radiation therapy to cns | 0;10 | SET OF CODES | 0:None 1:Radiation Given 7:Refused Radiation 8:Recommended, Unknown if Given 9:Unknown if Recommended/Given or Not Applicable | This is a code indicating whether radiation therapy was performed to the brain and/or central nervous system. | |
| .031 | radiation therapy to cns date | 0;17 | DATE-TIME | This is the date on which brain/CNS radiation therapy was initiated. | ||
| .04 | surgery of primary site | 0;4 | NUMERIC | Records the surgical procedure(s) performed to the primary site. For further information see FORDS page 135. | ||
| .041 | surgery of primary site date | 0;11 | DATE-TIME | Records the date of the most definitive surgical resection of the primary site performed as part of subsequent treatment. | ||
| .05 | radiation | 0;5 | SET OF CODES | 0:None 1:Beam radiation 2:Radioactive implants 3:Radioisotopes 4:Beam + implants or radioisotopes 5:Radiation, NOS 7:Refused radiation 8:Recommended, unknown if given 9:Unknown if administered | Identifies the type of radiation given as part of subsequent treatment. | |
| .051 | radiation date | 0;12 | DATE-TIME | This is the date on which radiation therapy was given. | ||
| .06 | chemotherapy | 0;6 | SET OF CODES | 00:None 01:Chemotherapy, NOS 02:Single agent 03:Multiagent 82:Not admin/contraindicated 85:Pt died prior to tx 86:Not admin, no reason given 87:Refused by pt 88:Unknown if admin 99:Unknown, death cert | Records the type of chemotherapy administered as subsequent treatment at this and at all other facilities. If chemotherapy was not administered, then this item records the reason it was not administered to the patient. Chemotherapy consists of a group of anticancer drugs that inhibit the reproduction of cancer cells by interfering with DNA synthesis and mitosis. For further information see FORDS pages 171-172. | |
| .061 | chemotherapy date | 0;13 | DATE-TIME | This is the date on which chemotherapy was initiated. | ||
| .07 | hormone therapy | 0;7 | SET OF CODES | 00:None 01:Hormone therapy 82:Not admin/contraindicated 85:Pt died prior to tx 86:Not admin, no reason given 87:Refused by pt 88:Unknown if admin 99:Unknown, death cert | Records the type of hormone therapy administered as subsequent treatment at this and all other facilities. If hormone therapy was not administered, then this item records the reason it was not administered to the patient. Hormone therapy consists of a group of drugs that may affect the long-term control of a cancer's growth. It is not usually used as a curative measure. For further information see FORDS pages 175-176. | |
| .071 | hormone therapy date | 0;14 | DATE-TIME | This is the date on which hormone/steroid therapy was initiated. | ||
| .08 | immunotherapy | 0;8 | SET OF CODES | 00:None 01:Immunotherapy 82:Not admin/contraindicated 85:Pt died prior to tx 86:Not admin, no reason given 87:Refused by pt 88:Unknown if admin 99:Unknown, death cert | Records the type of immunotherapy administered as subsequent treatment at this and all other facilities. If immunotherapy was not administered, then this item records the reason it was not administered to the patient. Immunotherapy consists of biological or chemical agents that alter the immune system or change the host's response to the tumor cells. For further information see FORDS pages 179-180. | |
| .081 | immunotherapy date | 0;15 | DATE-TIME | The date immunotherapy was started. | ||
| .09 | other treatment | 0;9 | SET OF CODES | 0:None 1:Other 2:Other - Experimental 3:Other - Double Blind 6:Other - Unproven 7:Refusal 8:Reccommended, unknown if administered 9:Unknown | Identifies other treatment that cannot be defined as surgery, radiation, or systemic therapy. For further informatin see FORDS page 186. | |
| .091 | other treatment start date | 0;16 | DATE-TIME | Records the date on which other treatment began at any facility. For further information see FORDS pages 184-185. | ||
| 1 | radiation sequence | 0;2 | SET OF CODES | 0:Not Applicable 2:Radiation Before Surgery 3:Radiation After Surgery 4:Both Before AND After Surgery 5:Intraoperative Radiation 6:Intraoperative Radiation with other radiation before/after surgery 9:Sequence Unknown | This is the sequence of beam radiation therapy performed. | |
| 2 | place | 0;3 | POINTER | 160.19 | This is the institution performing the treatment. | |
| 3 | subsequent therapy comments | 1;0 | WORD-PROCESSING | This is a multi-line free text field permitting comments to be entered. | ||
| 4 | interstitial radiation | 2;1 | SET OF CODES | 1:Yes 2:No, not recommended 3:Patient refused interstitial radiation 4:Radiation planned, but not given 9:Unknown | Record whether the patient received interstitial radiation. | |
| 5 | iodine 125 | 2;2 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether Iodine 125 was used interstitially. | |
| 6 | gold 198 | 2;3 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether Gold 198 was used interstitially. | |
| 7 | palladium 103 | 2;4 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether Palladium 103 was used interstitially. | |
| 8 | iridium 192 | 2;5 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether Iridium 192 was used interstitially. | |
| 9 | other interstitial, nos | 2;6 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether other isotopes were used interstitially. | |
| 10 | external radiation | 2;7 | SET OF CODES | 1:Yes 2:No, not recommended 3:Patient refused external radiation 4:Radiation planned, but not given 9:Unknown | Record whether the patient received external radiation. | |
| 11 | prostate region only | 2;8 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether the prostate region only was irradiated. | |
| 12 | prostate and pelvic nodes | 2;9 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether the prostate and pelvic nodes were irradiated. | |
| 13 | prostate & pelvic para-aortic | 2;10 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether the prostate and pelvic para-aortic nodes were irradiated. | |
| 14 | distant metastatic sites | 2;11 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether distant metastatic sites were irradiated. | |
| 15 | other external sites, nos | 2;12 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether other external sites were irradiated. | |
| 16 | radiation planned/given | 2;13 | SET OF CODES | 1:Yes 2:No, not recommended 3:Patient refused radiation therapy 4:Radiation planned, but not given 9:Unknown | Record whether the patient received subsequent radiation therapy. | |
| 17 | total rad dose (prostate) | 2;14 | SET OF CODES | 1:Less than 1999 rad 2:2000-3000 rad 3:3001-4000 rad 4:4001-5000 rad 5:5001-6000 rad 6:6001-7000 rad 7:More than 7001 rad 8:Not given 9:Rad dose unknown | Record the total (external) rad dose given to the prostate; this includes boost dosage. Do not include interstitial rad dose. If it is known that the patient received radiation therapy, but the amount given is unknown, code 9 (rad dose unknown). | |
| 18 | total rad dose (pelvic nodes) | 2;15 | SET OF CODES | 1:Less than 1999 rad 2:2000-3000 rad 3:3001-4000 rad 4:4001-5000 rad 5:5001-6000 rad 8:Not given 9:Rad dose unknown | Record the total (external) rad dose given to the pelvic nodes; this includes boost dosage. Do not include interstitial rad dose. If it is known that the patient received radiation therapy, but the amount given is unknown, code 9 (rad dose unknown). | |
| 19 | total rad dose (para-aortic) | 2;16 | SET OF CODES | 1:Less than 1999 rad 2:2000-3000 rad 3:3001-4000 rad 4:4001-5000 rad 5:5001-6000 rad 8:Not given 9:Rad dose unknown | Record the total (external) rad dose given to the para-aortic nodes; this includes boost dosage. Do not include interstitial rad dose. If it is known that the patient received radiation therapy, but the amount given is unknown, code 9 (rad dose unknown). | |
| 20 | chemotherapy planned/given | 2;17 | SET OF CODES | 1:Yes 2:No, not recommended 3:Patient refused chemotherapy 4:Chemotherapy planned, but not given 9:Unknown | Record whether the patient received chemotherapy. | |
| 21 | adriamycin | 2;18 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether Adriamycin was administered. | |
| 22 | cytoxan | 2;19 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether Cytoxan was administered. | |
| 23 | methotrexate | 2;20 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether Methotrexate was administered. | |
| 24 | 5-fluorouracil | 2;21 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether 5-Fluorourcil was administered. | |
| 25 | other | 2;22 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether other chemotherapy drugs were administered. | |
| 26 | hormone therapy planned/given | 2;23 | SET OF CODES | 1:Yes 2:No, not recommended 3:Patient refused hormone therapy 4:Hormone therapy planned, but not given 9:Unknown | Record whether the patient received hormonal therapy. | |
| 27 | estrogens | 2;24 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether estrogens were administered. Code 2 (no) if estrogens were not given. Estrogens include diethylstilbestrol (DES), Stilphostrol, TACE (chlorotrianisene), and Emcyt (estramustine phosphate). | |
| 28 | antiandrogens | 2;25 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether antiandrogens were administered. Code 2 (no) if antiandrogens were not given. The most widely used antiandrogen is Eulexin (fultamide). | |
| 29 | progestational agents | 2;26 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether progestational agents were administered. Code 2 (no) if progestational agents were not given. Progestational agents include Provera (medroxyprogesterone) and Megace (megestrol acetate). | |
| 30 | luteinizing hormone-releasing | 2;27 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether luteinizing hormone-releasing hormones were administered. Code 2 (no) if luteinizing hormone-releasing hormones were not given. Luteinizing hormone-releasing hormones (LH/RH) include Lupron (leuprolide) and Zoladex (goserelin). | |
| 31 | orchiectomy | 2;28 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether an orchiectomy was administered. Code 2 (no) if an orchiectomy was not given. | |
| 32 | other hormones | 2;29 | SET OF CODES | 1:Yes 2:No 9:Unknown | Record whether other hormones were administered. Code 2 (no) if no other hormones were given. | |
| 33 | recon/restore - delayed | 2;30 | NUMERIC | "Reconstruction/Restoration - Delayed" describes surgical procedures that improve the shape and appearance or function of body structures that are missing, defective, damaged, or misshapen by cancer or cancer-directed therapies. "Reconstruction/Restoration - Delayed" is limited to procedures started after the first course of cancer- directed therapy is complete or when it is unknown whether reconstruction was started during first or second course of therapy. | ||
| 34 | recon/restore - delayed date | 2;31 | DATE-TIME | |||
| 35 | scope of lymph node surgery | 2;32 | SET OF CODES | 0:None 1:Bx/aspiration, NOS 2:Sentinel Bx 3:Nodes removed, number unk 4:1-3 nodes removed 5:4 or more nodes removed 6:Sentinel + 3, 4 or 5, timing not stated 7:Sentinel + 3, 4, or 5, diff times 9:Unknown/NA | Indentifies the removal, biopsy, or aspiration of regional lymph node(s) at the time of surgery of the primary site or during a separate surgical event. For further information see FORDS pages 138-139. | |
| 36 | surgical proc/other site | 2;33 | SET OF CODES | 0:None 1:Nonprimary surgical proc 2:Nonprimary surgical proc/other regional sites 3:Nonprimary surgical proc/distant lymph node(s) 4:Nonprimary surgical proc/distant site 5:Combination of codes 9:Unknown | Records the surgical removal of distant lymph nodes or other issue(s)/organ(s) beyond the primary site. For further information see FORDS page 142. | |
| 37 | number of nodes removed | 2;34 | NUMERIC | Enter the number of regional lymph nodes removed. 00 for No nodes removed 01 for 1 node removed 02 for 2 nodes removed ... 90 for 90 or more nodes removed 95 for No nodes removed, aspiration performed 96 for Node removal as a sampling, number unknown 97 for Node removal as dissection, number unknown 98 for Nodes surgically removed, number unknown 99 for Unknown; not stated; death certificate only | ||
| 38 | scope of ln surgery date | 2;35 | DATE-TIME | This field records the date of the SCOPE OF LYMPH NODE SURGERY (#35) sub-field for this subsequent course of treatment. The date entered must be after or equal to the DATE DX (#3) field. | ||
| 39 | surgical proc/other site date | 2;36 | DATE-TIME | This field records the date of the SURGICAL PROC/OTHER SITE (#36) sub-field for this subsequent course of therapy. The date entered must be after or equal to the DATE DX (#3) field. | ||
| 40 | mets site resected | 2;37 | SET OF CODES | 0:None 1:Peritoneum 2:Lung 3:Pleura 4:Liver 5:Bone 6:Brain 7:Skin 8:Distant LNS 9:Other | This is the Metastatic Site Resected for this subsequent treatment. | |
| 41 | mets site resected date | 2;38 | DATE-TIME | This is the date the Metastatic Site was resected. The Date must be after or equal to the DATE DX (#3) field. | ||
| 42 | palliative care | 2;39 | SET OF CODES | 0:No palliative care 1:Surgery 2:Radiation 3:Systemic tx 4:Pain management 5:Surg, rad, and/or systemic tx w/o pain mgt 6:Surg, rad, and/or systemic tx w pain mgt 7:Palliative care, type unknown 9:Unknown, not stated | Identifies any care provided in an effort to palliate or alleviate symptoms. Palliative care is performed to relieve symptoms and may include surgery, radiation therapy, systemic therapy (chemotherapy, hormone therapy or other systemic drugs), and/or pain management therapy. |
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