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Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries

HCPCS code

Name of the Procedure:

Samarium Sam-153 Lexidronam Therapy
Technical or Medical Term: Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries (A9604)


This procedure involves the intravenous administration of a radioactive medication known as Samarium sam-153 lexidronam. It is utilized to relieve bone pain in patients with cancers that have spread to the bones.


Medical Conditions:

  • Pain from bone metastases, typically associated with cancers such as prostate cancer, breast cancer, or others that have spread to the bone.


  • To provide pain relief from bone metastases without the need for surgical intervention or more aggressive chemotherapy.
  • Improve the patient's quality of life by reducing pain and possibly decreasing the need for pain medications.


  • Patients experiencing significant pain from cancer that has metastasized to the bones.
  • Individuals who have not responded adequately to other pain management treatments.


  • Pre-procedure Instructions: Patients may be advised to stay hydrated before the procedure.
  • Diagnostic Tests: Blood tests to check kidney function, blood counts, and possibly imaging studies to confirm the extent of bone metastases.

Procedure Description

  1. Patient Preparation: The patient is taken to the nuclear medicine department and positioned comfortably.
  2. Administration: An intravenous (IV) line is inserted, and Samarium sm-153 lexidronam is administered through the IV.
  3. Tools and Equipment: The procedure uses standard IV equipment and involves the handling of radioactive materials.
  4. Anesthesia: No anesthesia or sedation is typically required for this procedure.


The entire administration process typically takes less than an hour, though the infusion itself is often completed within a few minutes.


Samarium sm-153 lexidronam therapy is usually performed in a hospital's nuclear medicine department or an outpatient clinic specifically equipped for handling radiopharmaceuticals.


  • Healthcare Professionals: A nuclear medicine physician or oncologist oversees the procedure, supported by a specialized nurse or nuclear medicine technologist.

Risks and Complications

  • Common Risks: Temporary drop in blood cell counts, leading to possible increases in the risk of infection, anemia, or bleeding.
  • Rare Risks: Allergic reactions or unexpected radiation effects beyond the targeted areas.
  • Complications Management: Regular blood tests are performed post-procedure to monitor the patient's blood cell counts, and supportive care is provided as needed.


  • Expected Benefits: Significant pain relief, often within a week or two after the procedure.
  • Timeline: Many patients experience pain reduction within days, and the effect can last for several months.


  • Post-Procedure Care: Minimal care required post-procedure. Patients can usually resume normal activities immediately but should follow any specific guidelines provided by their physician.
  • Recovery Time: Patients often need to rest for the remainder of the day post-infusion.
  • Follow-Up: Regular follow-up appointments to monitor blood counts and overall health, with additional imaging if needed.


  • Other Treatment Options: Traditional pain medications, external beam radiation therapy, other radiopharmaceuticals, or chemotherapy.
  • Pros and Cons: Samarium sm-153 lexidronam is less invasive than surgery and offers targeted pain relief, though it may not be suitable for all patients, particularly those with very compromised bone marrow function.

Patient Experience

  • During the Procedure: Patients might feel minimal discomfort from the IV insertion but should not feel pain from the medication itself.
  • After the Procedure: Some mild, transient side effects like fatigue might occur. Pain relief usually follows shortly after.
  • Pain Management: Most patients report a significant reduction in pain, thus potentially reducing their reliance on analgesics.

By providing a comprehensive overview, this markdown format ensures that patients and healthcare providers are well-informed about the procedure, benefits, risks, and post-care involved in Samarium sm-153 lexidronam therapy.

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