Name of the Procedure:

Injection, Porfimer Sodium, 75 mg

Common name(s): Photodynamic Therapy Injection
Technical/Medical term: Injection, Porfimer Sodium, 75 mg (HCPCS Code: J9600)

Summary

Photodynamic therapy involves injecting a drug called porfimer sodium that becomes active when exposed to light. This treatment helps to eliminate certain types of diseased tissues, such as cancer cells.

Purpose

This procedure addresses various medical conditions like esophageal cancer, lung cancer, and Barrett’s esophagus.
The primary goal is to destroy abnormal or cancerous tissues while preserving surrounding healthy tissue.

Indications

• Patients with esophageal cancer or lung cancer.
• Those with Barrett’s esophagus showing pre-cancerous changes.
• Non-surgical candidates for tumor removal.

Preparation

• Patients may need to fast for 6-8 hours prior to the procedure.
• Avoid certain medications, such as blood thinners, as instructed by the healthcare provider.
• Pre-procedure tests may include blood work and imaging studies.

Procedure Description

1. Initial Consultation: Discuss procedure details and assess patient's health condition.
2. Injection: Porfimer sodium is injected into the patient's bloodstream.
3. Activation: After 40-50 hours, the drug is activated using a specific type of light directed at the target tissue.
4. Destruction of Abnormal Tissue: The activated drug kills the affected cells.

Tools/Equipment: Injection syringe, light fibers or endoscope with light source.
Anesthesia/Sedation: Local anesthesia or mild sedation may be used to alleviate discomfort.

Duration

The entire process, including drug activation, can take from 2 to 4 days. The light activation part takes about 20-45 minutes.

Setting

This procedure is typically performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Physician or Oncologist
• Registered Nurse
• Anesthesiologist (if sedation is used)
• Technicians supporting with light equipment

Risks and Complications

• Common risks: Pain, swelling, and photosensitivity reactions.
• Rare risks: infection, bleeding, or accidentally damaging healthy tissue. Complications are typically manageable with medication or additional care.

Benefits

• Effective in targeting and destroying cancerous cells.
• Minimally invasive compared to surgical options.
• Recovery time is usually quicker and less intensive.

Recovery

• Avoid direct sunlight and bright indoor lights for at least 30 days post-procedure.
• Follow-up appointments for monitoring progress.
• Pain management as necessary with prescribed medications.
• Return to normal activities typically within a week, with some precautions.

Alternatives

• Surgical removal of tumors: More invasive but immediate removal.
• Radiation therapy: Effective but with potential for more side effects.
• Chemotherapy: Systemic treatment but with various side effects.

Pros and Cons: Photodynamic therapy is less invasive and targets specific tissues but requires multiple days and strict light exposure precautions post-treatment.

Patient Experience

During the injection, there might be minor discomfort. Light application involves mild to moderate discomfort which is managed with sedation or local anesthetics. Post-procedure, patients may experience skin sensitivity, slight swelling, and have to avoid light exposure for several weeks. Pain management and comfort measures will be provided to ensure a smoother recovery.