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With metastases to or beyond the regional lymph nodes. Persistent or recurrent following initial anticancer therapy.
Extending to the pelvic wall, lower portion of the vagina, or adjacent or distant organs. Persistent or recurrent following initial anticancer therapy. With metastases to distant (for example, para-aortic or supraclavicular) lymph nodes.
Consider under a disability until at least 18 months from the date of diagnosis. With metastases to or beyond the regional lymph nodes. Persistent or recurrent following initial anticancer therapy.
Carcinoma of the superior sulcus (including Pancoast tumors) with multimodal anticancer therapy (see 13.00E3c). Tumors of the mediastinum, as described in 1 or 2: 1.
For these exceptions, we usually need a longitudinal record of 3 months after therapy starts to determine whether the therapy achieved its intended effect, and whether this effect is likely to persist. This therapy may consist of a single modality or a combination of modalities; that is, multimodal therapy (see 13.00I4). If the treatment fails, the failure often happens within 6 months after the treatment starts, and there will often be a change in the treatment regimen. Whenever the initial planned therapy is multimodal, we usually cannot make a determination about the effectiveness of the therapy until we can determine the effects of all the planned modalities. We need corroborating evidence to document recurrence, such as radiological studies or findings on physical examination. We evaluate malignant melanoma that affects the skin (cutaneous melanoma), eye (ocular melanoma), or mucosal membranes (mucosal melanoma) under 13.29. Immunosuppressant therapy, such as frequent infections.
In some cases, we may need to defer adjudication until we can assess the effectiveness of therapy. We evaluate melanoma that is not malignant that affects the skin (benign melanocytic tumor) under the listings in 8.00 or other affected body systems. Bone marrow or stem cell transplantation is performed for a variety of cancers. If you undergo autologous transplantation (transplantation of your own cells or cells from your identical twin (syngeneic transplantation)), we will consider you to be disabled until at least 12 months from the date of the first treatment under the treatment plan that includes transplantation. We consider any residual impairment(s), such as complications arising from: a.
Thereafter, evaluate any residual impairment(s) under the criteria for the affected body system. Thereafter, evaluate any residual impairment(s) under the criteria for the affected body system.
We do not need to make a determination about the length or effectiveness of your therapy. We do not need to restrict our determination of the onset of disability to the date of the transplantation (13.05, 13.06, or 13.07) or the date of first treatment under the treatment plan that includes transplantation (13.28). If you undergo bone marrow or stem cell transplantation for any of these disorders, we will consider you to be disabled until at least 24 months from the date of diagnosis or relapse, or at least 12 months from the date of transplantation, whichever is later. The length of time we will consider you to be disabled depends on whether you undergo allogeneic or autologous transplantation.
Germ-cell cancer--progressive or recurrent following initial anticancer therapy.
Progressive or recurrent (not including biochemical recurrence) despite initial hormonal intervention. With visceral metastases (metastases to internal organs).
In some situations, very serious adverse effects may interrupt and prolong multimodal anticancer therapy for a continuous period of almost 12 months. We evaluate any post-therapeutic residual impairment(s) not included in these listings under the criteria for the affected body system. When the residual impairment(s) does not meet or medically equal a listing, we must consider its effect on your ability to do substantial gainful activity. We may consider your impairment to be disabling beyond this point when the medical and other evidence justifies it. When a listing does not contain such a specification, we will consider an impairment(s) that meets or medically equals a listing in this body system to be disabling until at least 3 years after onset of complete remission. Recurrent cancer (except local recurrence) after initial anticancer therapy. Thereafter, evaluate any residual impairment(s) under the criteria for the affected body system. Sarcoma or carcinoma of any type with regional or distant metastases. Carcinoma of the antrum with extension into the orbit or ethmoid or sphenoid sinus. Cancer with extension to the orbit, meninges, sinuses, or base of the skull. Primary central nervous system (CNS; that is brain and spinal cord) cancers, as described in 1,2 or 3: 1.
The residual effects of treatment are temporary in most instances; however on occasion, the effects may be disabling for a consecutive period of at least 12 months. In some listings, we specify that we will consider your impairment to be disabling until a particular point in time (for example, until at least 12 months from the date of transplantation). Consider under a disability for 12 months from the date of diagnosis.
Adenocarcinoma that is inoperable, unresectable, or recurrent. Squamous cell carcinoma of the anus, recurrent after surgery.