New Chemotherapy Targets Tumor

Traditionally, when cancer patients are treated with chemotherapy, the toxic drugs are delivered intravenously where they travel throughout the body. They often cause negative side effects such as fatigue, hair loss and nausea, and often damage other organs as they fight the cancer. Now, doctors are taking a new approach to treating cancers that they call regional therapeutics, or perfusion therapy. Perfusion therapy delivers the drug directly to the area of the body where the tumor is located. This eliminates the systemic side effects of traditional therapy.

First, doctors surgically remove as much of the tumor as they can. Then, blood flow to the organ or the area of the body where the tumor is located is temporarily cut off from the rest of the body. For two hours, a high dose of toxic medication is delivered to the tumor site. David Bartlett, M.D., surgical oncologist at the University of Pittsburgh Medical Center, says, "It's a technique of re-circulating chemotherapy through a region of the body." The procedure is often effective in a single treatment, but in some cases where the cancer comes back, multiple treatments can be performed.

The goal with perfusion therapy is to prolong patient survival and improve quality of life for the patient. Since cancer often does affect the whole body, Dr. Bartlett says it's unlikely that this procedure will make the cancer go away forever. He says, "We kind of take the disease in a step wise fashion and treat what we can see realizing that we may have not addressed the whole question." Specifically talking about liver treatment, he says, "We may not cure all of their disease but if we avoid the complications of liver failure by treating the disease in their liver, then we have prolonged their survival and significantly palliated them, made them feel better during their disease."

According to Dr. Bartlett, liver perfusion has been associated with a 75 percent chance of the tumor shrinking down to less than half the size that they start at, and that seems to be maintained for 14 to 16 months.

Perfusion therapy is for patients whose cancer has not spread throughout the body and is confined to one region. It is intended for individuals whose cancer is too large or cannot be surgically removed, but is still confined to one area. So far, it is being used to treat cancers of the abdominal cavity, liver, limb such as leg or arm, and the area around the lung.

Since the drug does not travel throughout the body, it does not have the systemic side effects often associated with chemotherapy treatment. Since such high doses are delivered to one organ, that organ may have some short-term effects. For example, in liver treatments, liver dysfunction can occur for a week or two.