Chemotherapy administration; intralesional, more than 7 lesions
CPT4 code
Name of the Procedure:
Chemotherapy Administration; Intralesional, More Than 7 Lesions
Summary
Chemotherapy administration intralesional is a specialized technique where chemotherapy drugs are directly injected into cancerous lesions. This method is frequently used when there are multiple (more than 7) localized tumors that are accessible for direct treatment.
Purpose
This procedure is aimed at treating certain types of localized cancers that are confined to specific lesions. The direct application of chemotherapy to the lesions can shrink or destroy the tumors, possibly limiting the side effects compared to systemic chemotherapy.
Indications
- Patients with multiple localized skin or soft tissue tumors.
- Conditions such as melanoma, Kaposi's sarcoma, or other cancers with multiple accessible lesions.
- Patients for whom systemic chemotherapy poses significant risks.
Preparation
Patients may need to:
- Undergo blood tests and imaging studies to determine the extent of the disease.
- Follow specific instructions about eating and drinking before the procedure.
- Adjust certain medications as advised by their healthcare provider.
Procedure Description
- The patient is positioned comfortably, and the lesions are identified.
- Local anesthesia is administered to numb the area around the lesions.
- A fine needle is used to inject the chemotherapy drug directly into each identified lesion.
- This process is repeated for all targeted lesions.
- Post-injection, the treated areas are cleaned and bandaged if necessary.
Duration
The procedure typically takes between 30 minutes to 1 hour, depending on the number and size of the lesions.
Setting
The procedure is usually performed in a hospital or outpatient clinic setting.
Personnel
- An oncologist or a specialized physician administers the chemotherapy.
- Nurses assist during the procedure and provide pre- and post-procedure care.
- If needed, an anesthesiologist may be involved for sedation.
Risks and Complications
- Localized pain, swelling, or infection at the injection sites.
- Potential for localized skin reactions or ulceration.
- Rare risk of systemic effects from the chemotherapy drugs.
Benefits
- Targeted treatment of cancerous lesions with potentially fewer systemic side effects.
- Direct application may result in more effective control of the localized tumors.
- Recovery may be faster compared to systemic chemotherapy.
Recovery
- Patients might experience some discomfort or redness at the injection sites.
- They may be advised to avoid strenuous activities for a few days.
- Follow-up appointments are necessary to monitor the lesions' response and manage any side effects.
Alternatives
- Systemic chemotherapy: involves treating the whole body but may have more systemic side effects.
- Surgical excision: removing the lesions surgically.
- Radiation therapy: using high-energy rays to shrink tumors. Each alternative has its pros and cons, which should be discussed with a healthcare provider.
Patient Experience
Patients may feel a stinging or burning sensation during the injections, which is minimized with local anesthesia. Post-procedure, mild discomfort or itching might be experienced at the injection sites. Pain management and comfort measures, such as topical creams or pain relievers, will be provided if necessary.