O0110. Special Treatments, Procedures, and Programs: Cancer Treatments

Navigating a cancer diagnosis is a complex and emotional journey, where one of the most critical aspects is planning for chemotherapy. Ensuring a comprehensive care plan is essential to manage the physical, emotional, and logistical challenges that come with chemotherapy treatment. In this article, we will delve into the intricacies of care planning for chemotherapy, beginning with an overview of the special treatments, procedures, and programs designed specifically for cancer patients. Understanding these elements is vital for patients and their families to make informed decisions and optimize their care experience.

Select Chemotherapy based on the route of administration: Oral, IV, Other

If chemotherapy is administered intravenously select O0110A2. Common IV chemotherapy drugs include:

• • Altretamine
  • Bendamustine
  • Busulfan
  • Carboplatin
  • Chlorambucil
  • Cisplatin
  • Cyclophosphamide
  • Dacarbazine

If chemotherapy administered orally (e.g., pills, capsules, or liquids the patient swallows) select O0110A3. This sub-element also applies if the chemotherapy is administered enterally (e.g., feeding tube/PEG). Common ORAL/ENTERAL chemotherapy drugs include:

• • Methotrexate
  • Capecitabine
  • Carboplatin
  • Cisplatin
  • Fluorouracil
  • Cyclophosphamide
  • Etoposide
  • Hydroxyurea
  • Paclitaxel
    
    

If chemotherapy administered in a way other than intravenously, enterally, or orally (e.g., intramuscular, intraventricular/intrathecal, intraperitoneal, or topical routes) select O0110A10.

Diagnosis Coding for the Patient Receiving Chemotherapy

If the patient is receiving home visits for chemotherapy administration (IV, IM, etc), 'Encounter for antineoplastic chemotherapy Z51.11' should be included in the ICD coding profile. The cancer diagnosis must also be included. The ICD-10 diagnoses for neoplasms are listed under C00-D49.

Patient/Caregiver Teaching on Managing Side Effects of Chemotherapy

This guide to careplanning for chemotherapy helps patients and caregivers with knowledge to manage chemotherapy side effects, and complete a smoother treatment journey.

Adapted from Coping with Chemotherapy, UCSF

1. Prevent Infection

•    With a fever 101° Fahrenheit (38.3° Celsius) or above, with or without chills, call the doctor or nurse immediately. If the patient cannot reach the cancer specialist, go to an emergency room.
•    Keep a thermometer in the home and know how to take a temperature. Do not eat, drink or smoke for 10 minutes before taking a temperature. Leave the thermometer under the tongue for three minutes. If still unsure of how to take your temperature, ask your doctor or nurse.
•    Call the doctor or nurse as soon as possible if a cough, sore throat, pain or burning on urination occurs.
•    Wash hands frequently with soap and water to prevent infection.
•    Do not eat raw foods such as sushi and sashimi, Caesar salad or milk shakes made with raw eggs, until chemotherapy is completed and blood counts have returned to adequate levels. Raw foods may carry bacteria that can lead to infection. Make sure to thoroughly wash fruits and vegetables.
•    Always tell the doctor before going to the dentist.

2. Nausea and/or vomiting

•    Eat a small, light meal before your chemotherapy appointment. Most people do better if they have something in their stomach.
•    Eat what sounds good to you. In general, starches such as rice, bread, potatoes, hot cereals and puddings are well tolerated.
•    Try not to skip meals. An empty stomach will worsen all symptoms. If you don't feel like sitting down to a meal, try nibbling on something that appeals to you.
•    Drink plenty of fluids. Herbal teas, water, sports drinks and diluted juices are recommended more than soda.
•    Avoid unappealing smells.
•    Freeze meals so you don't have to cook. Ask your family and friends to help with meals, especially following chemotherapy when you are most likely to feel nauseated.

3. Managing overwhelming fatigue

•    Plan your activities, such as grocery shopping, for a time when you feel the best.
•    If you have children, rest when they are napping. When you feel most tired, consider hiring a babysitter for a few hours so that you can relax or take a nap.
•    Take naps early in the day so you do not disturb your sleep pattern at night.
•    Consider exercising every day or several times a week. Good forms of exercise include swimming, walking and yoga.

4. Hair loss

•    Before possible hair loss, some people like to cut their hair short. The hair loss won't be quite so shocking if there is less hair to lose.
•    Put a towel over your pillow so that clean up in the morning will be easier while you are shedding your hair.
•    Buy a drain catch for your shower. Other people choose to shave their head hair when hair loss begins.
•    If buying a wig, take a friend for emotional support

5. Appetite and taste changes

•    Eat what appeals to you during this time.
•    Eat foods that are warm rather than hot.
•    Avoid places where food is being cooked, such as the kitchen at dinnertime.
•    Avoid unappealing smells.
•    Try to drink eight to 10 glasses of fluid a day.

6.  Mouth Sores

• Brush your teeth with a soft toothbrush three times daily.
• Rinse your mouth with a solution of one teaspoon baking soda and one teaspoon of salt, diluted in a glass of lukewarm water, three or four times daily.
• Most commercial mouthwashes contain alcohol. Ask your health care provider about mouthwashes that are not irritating to your mouth.
• Ulcer-ease is a commercial product that may provide temporary relief from sores.
  
  

7. Neuropathy

• Tight shoes and socks can worsen pain and tingling and may lead to sores that won't heal. Wear soft, loose cotton socks and padded shoes.
• If you have burning pain, cool your feet or hands in cold, but not icy, water for 15 minutes twice a day.
• Massage your hands and feet, or have someone massage them for you, to improve circulation, stimulate nerves and temporarily relieve pain.