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Code metronomic chemotherapy as chemotherapy. Metronomic chemotherapy, also referred to as low-dose metronomic (LDM) chemotherapy, is an emerging cancer treatment approach which administers relatively low doses of traditional chemotherapy drugs over a long period of time and without ‘breaks’ in treatment. By using lower doses this method of treatment minimizes the side effects of traditional chemotherapy.

For tumors diagnosed prior to 2007:

Code 8720 [malignant melanoma]. Assign the histology code based on the histology stated in the final diagnosis on the pathology report. The pathology report must say melanoma arising in junctional nevus to use the code 8740/3 [Malignant melanoma in junctional nevus].

For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules.

For tumors diagnosed prior to 2007:

Assign 8046 [non-small cell carcinoma] for "non-small cell carcinoma" of the pancreas. If necessary, override any site/type edits.

For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules.

A tumor considered to be malignant is reportable. "Considered to be" is an UNambiguous term.

For cases diagnosed 1998-2003:

Code the largest dimension mentioned, since that is the standard rule for coding tumor size. Keep in mind that tumor size is not used in analysis for certain sites such as stomach, colon & rectum, ovary, prostate, and urinary bladder. Tumor size is important for analysis for certain sites such as lung, bone, breast, and kidney.

For cases diagnosed 1/1/2010 and later, use the Hematopoietic & Lymphoid Neoplasm Manual for instructions on coding aspirin, blood thinners/anti-clotting medications, and transfusions in the field "Other Treatment."

For cases diagnosed 5/1/2002 12/31/2009, use the instructions in the SEER Manual and the instructions in "Abstracting and Coding Guide for the Hematopoietic Diseases" to code aspirin, blood thinners/anti-clotting medications, and transfusions in the field "Other Treatment."

For cases diagnosed 1/1/2001 04/30/2002 use the instructions in the SEER Manual for collection of aspirin, blood thinners/anti-clotting medications, and transfusions in the field "Other Treatment."

Prior to 1/1/2001, these treatment modalities were not collected.

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Code the histology to 9732/3 [multiple myeloma].

Ambiguous terminology is used to accession cases (determine reportability) because it has been used for over 30 years to do so. Any deviation from using ambiguous terminology to determine case reportability would cause the reporting of incidence counts to vary. In this case, there was a reportable, ambiguous terminology diagnosis of multiple myeloma on the pathology report.

The instruction "Do not code histology based on ambiguous terminology" is intended to be used when there is a reportable and reportable stated in the diagnosis. Ambiguous terminology cannot be used to report the more specific diagnosis in cases of Heme & Lymphoid neoplasms. For example, if the pathology report final diagnosis was "Myeloproliferative neoplasm, probably Polycythemia Vera" the histology would be coded as myeloproliferative neoplasm, unclassifiable [9975/3]. The ambiguous terminology indicates that the genetic testing, immunophenotyping, etc., probably are not complete or are not diagnostic of the more specific disease. Wait to code the histology until there is a definite diagnosis given.

SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.

If the prostate cancer was diagnosed on autopsy, or the autopsy was performed within the staging timeframe (See 2004 SEER Manual, page 112), code SSF3 using the autopsy information.

Code the histology to 8575/3.

The instruction for coding duct and another non-duct histology not listed in Table 3 was inadverantly left out of the rules. The default is to code to the histology with the numerically higher ICD-O-3 code which is 8575/3.

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Reactive plasmacytosis is not reportable unless there is another indication of a reportable neoplastic disease. Reactive plasmacytosis is "a well known pathological process described as occurring in a variety of situations including infections, autoimmune disease, diabetes mellitus, sideropenia, liver cirrhosis and neoplastic conditions including leukemia. This process, by definition, is assumed to be a reaction of the immune system to an unknown or poorly defined stimulus." Based on this definition, reactive plasmacytosis is not the same as a plasmacytoma, although it may indicate the presence of a neoplastic process, such as leukemia.

SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.