Chemo targets

Vivien Williams: Malignant melanoma is the deadliest form of skin cancer. If caught early, melanoma can be cured but once it spreads, the disease can be tough to treat. The good news is that treatments keep getting better. Doctors at Mayo Clinic are using a new surgical technique to deliver high doses of chemo directly to areas that need it without exposing the rest of the body.

Patricia Simmons: The first one was in 1981 on my back.

Ms. Williams: Since that diagnosis of malignant melanoma 30 years ago, Patricia Simmons has battled several other instances of the disease.

Ms. Simmons: I’ve had my ankle operated on twice.

Ms. Williams: Recently, Patricia learned that the disease had spread throughout her right leg but because it was contained in her leg and it hadn’t spread elsewhere, Patricia was a candidate for a new procedure at Mayo Clinic called hypothermic isolated limb perfusion.

Richard Gray, M.D., Mayo Clinic surgical oncologist: Hypothermic isolated limb perfusion is a way of treating primarily melanoma but some other types of cancer that is isolated to a single limb.

Ms. Williams: Dr. Richard Gray says the technique allows them to deliver very high doses of chemotherapy that if given through an IV into your blood stream could damage organs such as your heart.

Dr. Gray:The doses are so high at those levels that it would cause problems with other organ systems, her bone marrow, her kidneys, if it was delivered to her entire body.

Ms. Williams: Here is how it works. First, Dr. Gray and his team isolate the main artery and vein that supply blood to the leg, then they tourniquet the leg and hook the artery and vein up to a bypass machine, similar to the ones used in open heart surgery. Once the machine is moving the blood through the leg, they administer the high-doses of chemotherapy. The doses they can deliver the arm or leg are 6 to 10 times higher than what would be safe or appropriate to give to the person’s whole body. For Patricia, the treatment worked. It effectively killed the cancer.

Ms. Simmons: I hope this is the end of melanomas for my leg.

Ms. Williams: And now knowing that the cancer is gone, Patricia can concentrate on living a full life and enjoy every minute with her family. Limb perfusion is not right for all people with melanoma but for the right patient, the therapy can be very beneficial. Now research shows that sun exposure can cause malignant melanoma so wear sunscreen, protective clothing and avoid the harmful rays.

For Medical Edge, I’m Vivien Williams.