UPMC
UPMC Children's Hospital of Pittsburgh
UPMC Magee-Womens Hospital
UPMC Immune Transplant and Therapy Center
Regional Perfusion Therapy for Advanced Melanoma
Melanoma is skin cancer that starts in the melanocytes. These are skin cells that make melanin, a pigment that gives your skin color.
Early detection is vital in treating melanoma. Left untreated, it can spread to other body parts and become more serious.
Surgeons can't always remove melanoma tumors because sometimes they are too advanced. In these cases, doctors sometimes use a special type of chemotherapy, called regional perfusion therapy.
Regional Perfusion Therapy For Advanced Melanoma
Chemo drugs work by killing cancer cells, or at least keeping them from growing and spreading.
People receive chemo in different ways:
- By taking a pill.
- Through a shot.
- Through medicine applied to the skin.
- By infusion through an IV.
Regional perfusion therapy is another type of chemo.
In this treatment, you receive a high dose of medicine in a single part of your body. The chemo stays in the affected region, leaving healthy tissue elsewhere in the body unharmed.
A few types of regional perfusion therapy can treat advanced melanoma. Our doctors will assess your cancer and talk with you about the treatment that's best for you.
For advanced melanoma confined to a limb, your care team might decide to use ILP.
In this surgery, doctors:
- Will give you general anesthesia, or medicine that makes you go to sleep.
- Use a tourniquet, a tight cloth, or rubber band to stop blood from flowing and keep the chemo in the right place.
- Make small cuts and attach the limb's veins and arteries to a machine that circulates the drug.
- Disburse a chemo drug called melphalan.
- Circulate the chemo throughout the limb for a set amount of time.
- Remove the drug and rinse the limb.
- Remove the tubes and stitch the veins and arteries to allow blood flow again.
Doctors heat the medicine when using regional perfusion therapy for advanced melanoma. Heating the drug, known as hyperthermia, helps the chemo kill cancer cells.
Some people have problems after ILP.
Potential complications include:
- Edema, or swelling from fluid build-up.
- Reddening of the skin.
- Blistering.
- Neuralgia, or sharp pains.
- Infection at the incision site.
Doctors sometimes use ILI therapy to treat advanced melanoma confined to a limb. In some ways, this treatment is like regional perfusion therapy.
During ILI, doctors:
- Use a tourniquet to stop the blood flow.
- Insert catheters, or thin tubes, through the skin into the limb's veins and arteries.
- Add the chemo, most often melphalan, with a needle.
- Remove the chemo and rinse the limb.
- Remove the tubes and let blood return to the limb.
There are differences between ILP and ILI therapies.
ILI is:
- Minimally invasive, which means it doesn't require large incisions.
- Done without anesthesia.
- A shorter treatment than ILP.
For some people, ILI therapy is a better choice.
Doctors will decide if it's right for you based on your age, cancer stage, and any other health problems you have.
ILI therapy also has potential complications, such as:
- Swelling of the limb.
- Skin redness or blistering.
- Infection at the catheter site.
- Neuralgia, or painful skin.
Melanoma sometimes spreads to other parts of the body, such as the lungs, brain, or liver. When it spreads to the liver, and surgeons can't remove it with surgery, doctors might suggest IHP therapy.
This type of perfusion treatment delivers a high dose of chemo to the liver to kill cancer cells. The liver's two-way blood supply enables doctors to keep the chemo in the liver, protecting healthy tissue elsewhere in the body from harm.
IHP is a surgical treatment, so you'll have anesthesia, or drugs to make you sleep.
Sometimes, people who have IHP suffer complications, such as:
- Pleural effusion, or fluid in the tissue between the lungs and chest.
- Bleeding or infection at the incision site.
- Anemia, or low red blood cell count.
- Sepsis, or inflammation from the body's immune response to bacteria.
- Liver failure, or loss of your liver function.
