Alternative to Amputation for Patients with Advanced Skin Cancer

Introduction

Patients diagnosed with metastatic melanoma on a limb have traditionally had limited options for fighting the often deadly form of skin cancer. Skin Cancer is defined as skin growths with differing causes and varying degrees of malignancy. The 3 most common malignant skin cancers are basal cell cancer, squamous cell cancer, and melanoma, each of which is named after the type of skin cell from which it arises. Skin cancer generally develops in the epidermis (the outermost layer of skin), so a tumor can usually be seen. This means that it is often possible to detect skin cancers at an early stage. Unlike many other cancers, including those originating in the lung, pancreas, and stomach, only a small minority of those affected will actually die of the disease, though it can be disfiguring. Melanoma survival rates are poorer than for non-melanoma skin cancer, although when melanoma is diagnosed at an early stage, treatment is easier and more people survive.

Main Item

Surgery is often impossible or would require large portions of tissue be removed - even the entire arm or leg. Northwestern Medicine 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 limb. A high-dose of heated chemotherapy medication is then injected into a main artery of the affected 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 member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

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."

For patients like Larry Black, who was diagnosed with melanoma in the fall of 2010, hearing that an alternative treatment was available provided hope at a time when he felt like he was in a losing battle with cancer.

"Before coming to Chicago, I had undergone several treatments that failed to get rid of the cancer," said Black. "I was watching the spots on my arm grow and was worried nothing could be done to stop it from spreading. When I got a second opinion from Dr. Bilimoria and learned there may be a different treatment that could help, I had a renewed sense of hope and was ready to keep fighting."

Black was the first patient to be treated with isolated limb infusion at Northwestern Memorial.

"There has been a noticeable decrease in the number and size of the tumors on Larry's arm and he no longer requires pain medication," said Bilimoria.

Black is grateful he learned about this option and thankful that he did not have to turn to amputation. "I need this arm to hold my fishing rod," said Black.

The outpatient procedure takes approximately two hours to complete. Side effects are limited, but the limb must be monitored closely in the hospital for a few days following surgery.

Attribution/Source(s):

This quality-reviewed publication was selected for publishing by the editors of Disabled World due to its significant relevance to the disability community. Originally authored by Northwestern Memorial Hospital, and published on 2011/12/16 (Edit Update: 2021/11/11), the content may have been edited for style, clarity, or brevity. For further details or clarifications, Northwestern Memorial Hospital can be contacted at nm.org. NOTE: Disabled World does not provide any warranties or endorsements related to this article.

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Cite This Page (APA): Northwestern Memorial Hospital. (2011, December 16 - Last revised: 2021, November 11). Alternative to Amputation for Patients with Advanced Skin Cancer. Disabled World. Retrieved September 19, 2024 from www.disabled-world.com/health/cancer/melanoma/alternative.php

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