Healthbeat Report: Targeting Cancer Cells

December 15, 2011 (CHICAGO)

Anneliese Nitzschke knows the power of a tried and true recipe. But she's not opposed to trying something new. So when doctors at Advocate Illinois Masonic Medical Center told her about a unique formula to treat the melanoma spreading in her left leg she was game.

"I guess he mentioned I was the first one, you know. I said, oh my goodness," said Nitzschke.

The cancer doctors were offering a very specialized procedure called isolated limb infusion or ILI. Nitzschke would be first at the hospital to have it done. It's a complex but minimally invasive technique to control advanced melanoma or soft tissue carcinoma of the arm or leg. What makes the procedure so unusual is that chemotherapy is delivered directly to the affected limb - and that's it. The rest of the body is basically cordoned off so the toxic drugs only circulate in the cancerous area.

"The beauty of this procedure is you can give larger and stronger amounts of chemotherapy than you could if you were trying to give it to the whole body," said Dr. Ajay Maker, a surgical oncologist at UIC who is spearheading the approach at Advocate Illinois Masonic Hospital.

Only a handful of centers around the country perform isolated limb infusion and slowly it's gaining attention.

"We know we can get a response or a disappearance or at least shrinkage, maybe 60 percent of all patients that undergo this procedure," said Dr. Maker.

So how does it work? The patient is anesthetized and the flow of blood to and from the limb is temporarily stopped with a tight band. Small flexible tubes attached are put into an artery so the blood can be circulated and then a very potent amount of the anti-cancer drugs are pumped in. The limb is also heated. Surgeons think that helps make the chemo more effective.

"We manually circulate the blood throughout the leg, so the chemotherapy gets to every cell in the whole limb. And at the end we flush the chemo out and release the tourniquet," said Dr. Maker.

It takes about two hours and that's it.

Nitzschke had been battling the melanoma on and off for 30 years. Her leg was full of scars and holes as each new growth was surgically removed. Amputation was a likelihood until this option came along. Doctors say she was a perfect candidate because the cancer had not spread to other parts of her body.

"We hope now that is still working when [he] takes the rest away," Dr. Maker.

Dr. Maker says of the nine lesions they could see some have since disappeared since the treatment six months ago and the rest have shrunk considerably.

This localized chemo treatment can be done again if the cancerous lesions return. Studies show it is effective and safe but more research is planned. There's also hope this approach can eventually be used to treat other cancers confined to certain organs. And just this week, Northwestern Memorial Hospital announced it will also offer this treatment.

Advocate Illinois Masonic Medical Center

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