There are many different approaches used in the treatment of recurring melanoma, such as chemotherapy, radiation therapy, combination methods and various surgical procedures. In the case of a melanoma which returns on a patient's limb despite other attempts to bring it under control, isolated limb perfusion may be the next line in treatment.
Isolated Limb Perfusion Treatment
A limb perfusion is carried out by a surgeon and as its name suggests, involves surgically isolating the leg through the use of a tourniquet and catheters in order to stop chemotherapy from leaking to other areas of the body. It is the job of one of these catheters to transfer blood which has been taken out of the leg to a machine responsible for mixing chemotherapy and oxygen while the other catheter then returns this mixture back to the leg. Both the limb affected and the chemotherapy medication are usually heated to a specific temperature resulting in greater effectiveness.
The isolated limb perfusion procedure will typically take a maximum of just one hour, following which the catheters are removed. Although the majority of patients undergoing an isolated limb perfusion will recover well from the procedure this may take a good few weeks and thus it is best to not plan any events during this time period.
Benefits of Isolated Limb Perfusion to Treat Recurring Melanoma
One of the major benefits of using this approach in the treatment of recurring melanoma is that unlike usual approaches to chemotherapy this method means that the rest of the body will actually only receive a very small amount of the chemotherapy. In addition, the procedure is typically a single treatment thus allowing the patient to be treated quickly and have less disruption to normal life in comparison to being required to attend regular outpatient chemotherapy sessions. Studies have also indicated that this approach offers patients a 20-25% increase in survival in contrast to other forms of treatment for recurring melanoma.
Other research studies have also identified that an isolated limb perfusion procedure has the positive effects of being able to decrease both the size and the appearance of malignant tumours in a localised area for extended periods of time, making it more efficient than many other approaches to skin cancer treatment.
Limitations and Side-Effects of Isolated Limb Perfusion
As with most forms of treatment for melanoma and other forms of skin cancer, there are also risks and side-effects associated with the isolated limb perfusion approach to treatment. The procedure may result in local complications such as leg swelling, damage to nerves and even skin breaking down. Further risks related to isolated limb perfusion include the following: bleeding, blood clots and a temporary decrease in red, white and clotting blood cells.
Therefore, this form of cancer treatment should not be entered into lightly with the worst case scenario, particularly if post-operative care is not taken up possibly resulting in amputation.
As highlighted above, treatment for recurring melanoma may involve undergoing an isolated limb perfusion which is usually carried out as a single treatment. However, in addition to several benefits of this procedure there are several side-effects which should ideally be discussed in advance.
Sources:
Kenet, B. & Lawler, P. (1994) Saving Your Skin London: Four Doors Eight Windows
McClay et al. (2004) 100 Questions and Answers About Melanoma and Other Skin Cancers Massachusetts: Jones and Bartlett
Kate Le Page - Kate Henning-Le Page writes about eating disorders, body image and recovery issues. She specializes in anorexia recovery.
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