Name of the Procedure:

Injection, Degarelix, 1 mg (HCPCS Code: J9155)

• Common Names: Degarelix injection, Firmagon injection
• Technical Names: Gonadotropin-releasing hormone (GnRH) receptor antagonist injection

Summary

The injection of degarelix is a medical treatment involving the administration of a medication known as degarelix. This medication is typically used for managing hormone-sensitive advanced prostate cancer by reducing levels of testosterone.

Purpose

The procedure addresses:

• Advanced hormone-sensitive prostate cancer.

Goals of the procedure:

• To rapidly reduce testosterone levels, which helps to slow the growth of prostate cancer cells.

Indications

• Patients with advanced or metastatic prostate cancer.
• Individuals experiencing symptoms due to high testosterone levels that promote cancer growth.

Preparation

• Pre-Procedure Instructions:
  • No fasting is generally required.
  • Patients should inform their doctor of all medications they are taking.
• Diagnostic Tests/Assessments:
  • Blood tests, including PSA (Prostate-Specific Antigen) levels.
  • Assessment of hormone levels and general health check.

Procedure Description

1. Step-by-Step Explanation:
   • The patient will lie or sit comfortably.
   • The injection site, often the abdomen, is sterilized with antiseptic.
   • A subcutaneous injection of degarelix is administered directly under the skin.
2. Tools and Equipment:
   • Sterile syringe and needle.
   • Degarelix medication.
3. Anesthesia/Sedation:
   • Local anesthesia is typically not required, but if needed, a topical anesthetic can be applied to minimize discomfort.

Duration

• The injection takes approximately 5-10 minutes to administer.

Setting

• Can be performed in various settings, such as:
  • Outpatient clinic.
  • Doctor’s office.
  • Hospital administration area.

Personnel

• The procedure is usually administered by:
  • A registered nurse (RN).
  • A medical doctor (MD) or healthcare provider overseeing the treatment.

Risks and Complications

• Common Risks:
  • Mild pain or redness at the injection site.
  • Hot flashes.
  • Weight gain.
  • Tiredness.
  • Nausea.
• Rare Risks:
  • Allergic reactions.
  • Significant injection site reactions, such as swelling or infection.
  • Liver function changes.

Benefits

• Rapid reduction in testosterone levels, potentially leading to:
  • Slower progression of prostate cancer.
  • Symptom relief.
• Positive effects may start to be noticeable within a few days to weeks.

Recovery

• Post-Procedure Care:
  • Monitor the injection site for any adverse reactions.
  • Follow any specific care instructions provided by the healthcare provider.
• Expected Recovery Time:
  • Minimal to no downtime is usually required; normal activities can often be resumed immediately.
  • Follow-ups typically depend on the treatment plan and overall health.

Alternatives

• Other Treatment Options:
  • Surgical castration (orchiectomy).
  • Other hormone therapies (e.g., Luteinizing Hormone-Releasing Hormone (LHRH) agonists).
• Pros and Cons:
  • Degarelix provides rapid testosterone suppression without an initial surge (flare) in hormone levels, unlike some alternative hormone therapies.
  • Surgical options are more invasive, with permanent effects.

Patient Experience

• During the Procedure:
  • The patient might feel a slight pinch or sting from the needle and some pressure during the medication administration.
• After the Procedure:
  • Possible mild discomfort or tenderness at the injection site.
  • Pain management typically involves over-the-counter pain relievers if needed.
  • Instructions will be provided for monitoring the injection site and handling any minor side effects.