Name of the Procedure:

Injection of mitomycin, 5 mg (HCPCS Code: J9280)

• Common Name: Mitomycin Injection
• Medical Term: Mitomycin Chemotherapy Injection

Summary

The injection of mitomycin is a simple medical procedure where a chemotherapy drug called mitomycin is administered. This drug helps in treating certain types of cancer by stopping the growth of cancer cells.

Purpose

• Medical Conditions Addressed: Mitomycin is often used for cancers of the bladder, stomach, pancreas, and other areas.
• Goals/Outcomes: To slow or stop the growth of tumor cells, reduce tumor size, and improve quality of life. This will diminish symptoms caused by the cancer and possibly lead to remission.

Indications

• Symptoms/Conditions: Tumors that cannot be surgically removed, tumors that have metastasized, or recurrent cancers.
• Patient Criteria: Patients with a confirmed diagnosis of a relevant type of cancer that has shown to respond to mitomycin.

Preparation

• Pre-Procedure Instructions: Typically, patients may need to avoid eating or drinking for several hours before the procedure if sedation is planned. Specific instructions will depend on the patient's overall treatment plan.
• Diagnostic Tests: Blood tests, imaging studies (like CT scans or MRIs), and sometimes urine tests to assess baseline organ function and cancer status.

Procedure Description

1. Setting Up: The patient is positioned comfortably. The injection site is usually decided based on the cancer’s location.
2. Administration: Mitomycin is administered via an intravenous (IV) line, ensuring a direct route into the bloodstream.
3. Monitoring: During the process, vital signs and patient comfort are continuously monitored.
   • Tools/Equipment: IV administration set, sterile needles, syringes, mitomycin vial.
   • Anesthesia/Sedation: Generally not required, but local anesthetic may be applied to minimize any discomfort at the injection site.

Duration

The procedure itself typically takes around 30 minutes, but the total time including setup and monitoring may be up to a few hours.

Setting

This procedure is typically performed in a hospital or an outpatient oncology clinic.

Personnel

• Primary Personnel: Oncologist, chemotherapy nurse.
• Additional Personnel: Pharmacist (for drug preparation), and in some cases, a physician's assistant.

Risks and Complications

• Common Risks: Nausea, vomiting, fatigue, hair loss, low blood cell counts.
• Rare Risks: Severe allergic reactions, severe infections due to immunosuppression, organ damage (kidneys, liver).

Benefits

• Expected Benefits: Reduction in tumor size, relief from cancer-related symptoms, potential improvement in overall survival.
• Realization: Benefits may be noticed within a few weeks to months depending on the cancer type and response to treatment.

Recovery

• Post-Procedure Care: Hydration is encouraged, and anti-nausea medications may be provided.
• Recovery Time: Recovery varies, but most patients can resume normal activities within a day. Regular follow-up appointments will be scheduled for monitoring and managing side effects.

Alternatives

• Other Treatments: Surgical removal of the tumor, radiation therapy, other chemotherapy agents, targeted therapy, immunotherapy.
• Pros and Cons: Each alternative varies in efficacy, side effects, and suitability based on individual patient factors. Surgery may provide more immediate results but is invasive; other chemotherapies might have different side effect profiles.

Patient Experience

• During Procedure: The patient might feel a slight prick at the injection site and may experience slight discomfort during the infusion.
• Post Procedure: Fatigue and other side effects commonly appear a few days post-injection. Pain management strategies including medication and supportive care can significantly ease discomfort.