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SEER Inquiry System - Report
Produced: 05/09/2026 8:30 AM
Question 20260012
Inquiry Details
References:
#1: SEER*Rx. Thyrogen
#2: 2026 SEER Manual. Appendix C Coding Guidelines, Thyroid
Question:
First Course of Therapy/Hormone Therapy--Thyroid: Is Thyrogen (thyrotropin alpha) coded as hormone therapy when a patient is given Thyrogen as part of planned 2-day Thyrogen Stimulated I-131 treatment for a papillary or follicular cancer? See Discussion.
Discussion:
SEER*Rx categorizes Thyrogen as Hormones and hormonal mechanisms/Thyroid stimulating hormone. Probably not cancer directed–verify with attending MD.
Answer:
Do not code Thyrogen as hormone therapy when given as a stimulating agent in I-131 therapy. The therapeutic agent is I-131.
The Thyrogen/thyroid stimulating hormone (TSH) is sensitizing the gland to absorb more I-131. Thyrogen/TSH is a trophic hormone so it can cause growth of cancer cells. Thyroid hormones are given in follicular and papillary thyroid cancers to suppress TSH. Although Thyrogen can promote cancer growth its use in Thyrogen stimulated I-131 radioactive therapy is justified (benefits exceed the risk), since the use is short (2 days) and the high amount of I-131 would kill cancer cells in addition to majority of thyroid tissue.
We will update the Thyrogen entry in SEER*Rx and clarify in the next release of the SEER manual, Appendix C Coding Guidelines for Thyroid.
