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SEER Inquiry System - Report
Produced: 12/20/2025 1:26 PM
Question 20230040
Inquiry Details
References:
2023 SEER Manual, 160-161
Question:
First Course Treatment/Hormone Therapy--Prostate: Is Lupron first course therapy in a patient who initially elected active surveillance for prostate cancer and then consented to treatment with Lupron? See Discussion.
Discussion:
in March, the patient with stage cT1c, Gleason grade 7, prostate cancer elected active surveillance. In April, the patient consented to treatment with Lupron. There was no evidence of disease progression. According to the rules on page 161 of the 2023 SEER manual, we think the answer is yes, but the reporting hospital states that this is second course therapy.
Answer:
Code Lupron as second course therapy and code active surveillance as first course therapy in this scenario. The 2023 SEER Manual states to code all treatment data items to 0 or 00 (Not done) when the physician opts for active surveillance, deferred therapy, expectant management, or watchful waiting. Assign code 2 to Treatment Status.
Active surveillance is not the same as "refusing treatment." Active surveillance is a valid option offered to the patient. The patient chose this option and later changed their mind. This is not a refusal of recommended treatment.
Document all the details in the appropriate treatment text fields.
