96417 Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up to 1 hour (List separately in addition to code for primary procedure)

Name of the Procedure:

Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up to 1 hour. Commonly known as "Sequential IV Chemotherapy Infusion."

Summary

Sequential IV Chemotherapy Infusion involves administering a secondary chemotherapy drug or substance intravenously following the initial primary infusion. This secondary infusion can last up to 1 hour and aims to target cancer cells that may not have responded to the primary medication.

Purpose

This procedure is specifically intended for cancer treatment. It aims to attack cancer cells from different angles using multiple drugs, increasing the likelihood of killing or controlling the malignant cells. The expected outcome includes reducing tumor size, halting cancer progression, and potentially putting the cancer into remission.

Indications

• Diagnosed cancer requiring multi-agent chemotherapy.
• Ineffectiveness of initial chemotherapy infusion alone.
• Specific cancer types known to respond better to combination therapy.
• Patient is in a physically suitable condition to endure multiple infusions.

Preparation

• Pre-procedure instructions may include fasting for a few hours prior.
• Adjustments in regular medication may be required.
• Diagnostic tests such as blood work, imaging studies, and physical assessments are often completed to evaluate the patient’s condition.

Procedure Description

1. Preparation Phase: The patient is seated comfortably, and vital signs are monitored.
2. Insertion of IV Line: An IV line is inserted into the patient's vein, typically in the arm.
3. Primary Infusion: The initial chemotherapy drug is administered.
4. Sequential Infusion: After the first drug, the second chemotherapy agent is prepared and infused through the same IV line, which can take up to 1 hour.
5. Monitoring: Throughout the infusion, patient’s reaction and vital signs are continuously monitored.
6. Completion: The IV line is removed, and the infusion site is dressed.

Tools and equipment include IV bags, infusion pumps, and monitoring devices. Sedation is generally not required, but local anesthetics may be used to numb the IV insertion site if needed.

Duration

The sequential infusion typically takes up to 1 hour, in addition to the duration of the primary infusion.

Setting

This procedure is performed in an outpatient clinic, a specialized chemotherapy infusion center, or a hospital outpatient department.

Personnel

• Oncology nurses who specialize in administering chemotherapy.
• Medical oncologists who prescribe and oversee the treatment plan.
• Pharmacy staff who prepare the chemotherapy drugs.
• Supportive staff for patient care and comfort.

Risks and Complications

Common risks include nausea, vomiting, fatigue, and localized pain at the IV site. Rare complications may include severe allergic reactions, infection at the injection site, or extravasation (leakage of the drug into surrounding tissue). Management of complications involves prompt medical intervention and supportive care.

Benefits

The expected benefits include enhancing the effectiveness of cancer treatment by using multiple drugs to target different weaknesses in cancer cells, potentially leading to better control of cancer growth and improved survival rates. Benefits are generally realized gradually over the treatment course.

Recovery

Post-procedure care involves monitoring for immediate adverse reactions, managing side effects with medications, and resting. Recovery time varies based on the individual’s response and overall health but generally includes minimal to moderate restrictions on physical activity. Follow-up appointments are essential for ongoing assessment and care.

Alternatives

Alternatives include oral chemotherapy, single-agent intravenous chemotherapy, radiation therapy, surgical options, and targeted biological therapies. Each alternative has its own set of advantages and disadvantages, which are discussed with the oncologist to tailor to the patient’s specific condition.

Patient Experience

Patients might experience mild discomfort or pain during the IV insertion, but this is generally well managed with local anesthetics. During and after the infusion, patients can feel tired, nauseous, or weak. Pain management includes prescribed medications and supportive care measures to maintain comfort.