Name of the Procedure:

Lomustine, oral, 10 mg (HCPCS Code: S0178)

• Common Names: CeeNU, CCNU
• Technical/Medical Term: Lomustine (oral administration).

Summary

Lomustine is an oral chemotherapy medication used to treat certain types of cancer. It belongs to a class of drugs known as alkylating agents that work by slowing or stopping the growth of cancer cells.

Purpose

Lomustine is primarily used to treat brain tumors, Hodgkin's lymphoma, and other cancers. The goal of the treatment is to reduce the size of the tumor or eliminate cancer cells, thereby improving symptoms and prolonging life.

Indications

• Brain tumors such as glioblastoma multiforme.
• Recurrent or refractory Hodgkin's lymphoma.
• Other malignant conditions as determined by the oncologist. Patients who have not found success with standard treatment protocols may be candidates for Lomustine.

Preparation

• Inform your healthcare provider about all medications you are currently taking.
• Regular blood tests are necessary before starting Lomustine to ensure adequate bone marrow function.
• No specific fasting or dietary restrictions unless advised by your healthcare provider.

Procedure Description

1. Prescription: Lomustine is given as an oral capsule. The dosing schedule is typically once every six weeks.
2. Administration: Swallowed whole with a glass of water, do not crush or chew.
3. Supportive Care: Antiemetics may be prescribed to manage potential nausea.

Duration

The administration of Lomustine itself is quick, as it involves swallowing a capsule. The effects of the drug and monitoring of side effects last several weeks.

Setting

This medication can be taken at home, but under close supervision by an oncologist.

Personnel

• Oncologist: Prescribes and monitors the treatment.
• Nursing Staff: Assists with patient education and monitoring side effects.

Risks and Complications

• Common: Nausea, vomiting, loss of appetite, low blood counts, and fatigue.
• Rare: Liver toxicity, pulmonary fibrosis, secondary malignancies. Management of side effects typically involves supportive medications and regular blood tests to monitor for toxicity.

Benefits

• Reduction in tumor size or halting cancer progression.
• Improvement in symptoms related to cancer. Benefits can be seen within a few weeks, but effectiveness varies by individual and cancer type.

Recovery

• Follow-up blood tests are required to monitor bone marrow function.
• Patients may experience fatigue and require rest.
• Avoid exposure to infections due to potential low white blood cell counts.
• Follow-up appointments for ongoing monitoring.

Alternatives

• Surgical interventions, radiation therapy, or other chemotherapy drugs.
• Each alternative has its pros and cons depending on the specific type of cancer and the patient’s overall health.

Patient Experience

• During the treatment: Patients may experience side effects like nausea and fatigue, which can be managed with medication.
• After the treatment: Continued monitoring for side effects; patients are encouraged to maintain a healthy lifestyle to aid recovery.
• Pain Management: Discomfort from side effects can be managed with over-the-counter or prescription medications as advised by the healthcare provider.