Form:	(EXPIRED) Canary: PASS Treatment v2.1

CDE ID	CDE Description
* 421	EDRN Participant ID (Go To: 422)
* 422	EDRN Site ID (Go To: 423)
* 423	EDRN Protocol ID (Go To: 929)
* 929	EDRN Staff ID of the person who collected the data: (Go To: 1219)
* 1219	Date of contact (MM/DD/YYYY): (Go To: 2827)
* 2827	Reason(s) for treatment: (Check all that apply) (Go To: 3214)
	Permissible Values (value): Participant elected definitive therapy without study-defined progression (8)
	Radical intervention with study-defined progression (10)
	Clinical recommendation of radical intervention without study-defined progression (11)
	Other, specify: (97) (Go To: 2828)
* 2828	Reason(s) for treatment: (Other, specify) (Go To: 3214)
* 3214	Number of subform loops to record 2: (Go To: 3201)
	Permissible Values (value): 1 (1)
	2 (2)
	3 (3)
	4 (4)
	5 (5)
	6 (6)
* 3201	Line number or identifier 2 (system-generated): (Go To: 2714)
* 2714	Procedure performed at the study site? (Go To: 2193)
	Permissible Values (value): No (0)
	Yes (1)
	Unknown (99)
* 2193	Treatment(s) received for prostate cancer: (Go To: 1869)
	Permissible Values (value): Chemotherapy (1)
	Radiation therapy (2) (Go To: 1864)
	Surgery (3)
	Hormone therapy alone (8)
	Hormone therapy in combination with another treatment (10)
	Other, specify: (97) (Go To: 2192)
* 2192	Treatment received for prostate cancer (Other, specify): (Go To: 1869)
* 1864	Radiation treatment type: (Go To: 1868)
	Permissible Values (value): Conformal (1)
	IMRT (2)
	Brachytherapy-Permanent Low Dose (3)
	Brachytherapy-Temporary High Dose (4)
	Proton beam (5)
	SBRT/Cyberknife (6)
	IGRT (Image guided radiation therapy) (7)
	VMAT (volumetric modulated arc therapy) (8)
	Other, specify: (97) (Go To: 2829)
* 2829	Radiation treatment type: (Other, specify) (Go To: 1868)
1868	Radiation dose/treatment (Gy): (Go To: 1869)
* 1869	Treatment start date (MM/DD/YYYY): (Go To: 1929)
1929	Treatment stop date (MM/DD/YYYY): (Go To: 1097)
1097	Comments (do not include any participant identifiers) (Go To: End of Form)