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Chemotherapy administration; intralesional, up to and including 7 lesions

CPT4 code

Name of the Procedure:

Chemotherapy Administration; Intralesional, Up to and Including 7 Lesions

Summary

Chemotherapy administration intralesionally involves injecting anti-cancer drugs directly into cancerous lesions on the skin or just below it. This procedure targets up to seven lesions at a time to attack cancer cells locally.

Purpose

The procedure is performed to treat localized skin cancers or lesions. The goal is to shrink or eliminate cancerous growths while minimizing the exposure of healthy cells to chemotherapy drugs.

Indications

  • Presence of skin cancer, particularly melanoma or basal cell carcinoma.
  • Localized tumors with clearly defined lesions.
  • Patients where systemic chemotherapy is not an option or those who require adjunct local treatment.

Preparation

  • Patients may be advised to avoid certain medications that can increase bleeding risk.
  • Fasting is not usually required, but patients should follow specific instructions given by their healthcare provider.
  • Pre-procedure imaging or biopsy may be needed to determine the extent of the lesions.

Procedure Description

  1. The area around the lesions is cleaned and sterilized.
  2. Local anesthesia may be applied to numb the area.
  3. A syringe containing the chemotherapy drug is prepared.
  4. The healthcare provider injects the drug directly into the cancerous lesions.
  5. The procedure is repeated for up to seven lesions.
  6. The area is monitored for immediate reactions.

Duration

The procedure typically takes 30 minutes to an hour, depending on the number of lesions treated.

Setting

This procedure is usually performed in an outpatient clinic or hospital setting.

Personnel

  • A dermatologist or oncologist typically performs the procedure.
  • A nurse assists with preparation and monitoring.
  • An anesthesiologist may be present if any sedation is required.

Risks and Complications

  • Common: Pain, redness, swelling at the injection site.
  • Rare: Infection, allergic reaction, necrosis of skin tissue.

    Benefits

  • Directly targets cancerous cells with minimal impact on healthy cells.
  • May shrink or eliminate tumors effectively.
  • Quick recovery time.

Recovery

  • Post-procedure care involves keeping the injection site clean and monitoring for signs of infection.
  • Most patients can resume normal activities within a day.
  • Follow-up appointments are used to assess the effectiveness and plan further treatment.

Alternatives

  • Topical chemotherapy creams.
  • Systemic chemotherapy.
  • Radiation therapy.
  • Surgical removal of lesions.

Pros and cons of alternatives vary; systemic treatments may offer broader cancer control but with more side effects, while surgery is more invasive.

Patient Experience

  • Patients may feel slight discomfort or pain during injections.
  • Local numbing agents help reduce pain.
  • Minimal downtime expected, with most patients resuming normal activities shortly after the procedure.
  • Pain management with over-the-counter pain relievers, if necessary.

Medical Policies and Guidelines for Chemotherapy administration; intralesional, up to and including 7 lesions

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