December 15, 2011

Treatment Offers Alternative to Amputation for Patients with Advanced Skin Cancer

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Patients diagnosed with metastatic melanoma on a limb have traditionally had limited options for fighting this form of skin cancer. Surgery is often impossible or would require large portions of tissue to be removed—even the entire arm or leg. Northwestern Medicine®, Chicago, Illinois, surgical oncologists are now offering an alternative approach that focuses on saving the limb while eliminating or shrinking the cancer, and may avoid the need for radical surgery altogether. The procedure, called isolated limb infusion, is performed at only a handful of medical centers across the country due to the complexity of the approach and expertise of the team required.

During the procedure, doctors use a tourniquet to temporarily stop blood flow to the affected limb. A high dose of heated chemotherapy medication is then injected into a main artery of that limb using a catheter to target the cancer. By isolating the limb, doctors are able to prevent the otherwise toxic high-dose chemotherapy drugs from affecting other organs. Following the treatment, drugs are flushed out through the main vein with a second catheter and circulation to the limb is returned to normal.

“This is a remarkable and frequently effective option for treating patients who otherwise would face amputation or disfiguring surgery,” said Karl Bilimoria, MD, surgical oncologist at Northwestern Memorial and a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago.

Melanoma can take over a patient’s arm or leg without having spread to other places in the body. In those cases, this treatment allows the limb to be treated and preserved. According to Bilimoria, approximately two-thirds of patients will significantly benefit from the treatment, with noticeable shrinkage of the tumor in as little as one month.

“Isolated limb infusion is capable of providing long-term tumor control and better long-term survival,” said Bilimoria, who is also an assistant professor of surgery at Northwestern University Feinberg School of Medicine. “We are pleased to be able to offer an alternative that can increase their chance of survival, preserve their limb, and improve their quality of life.”

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