UPMC On Topic Transcript -
Regional Perfusion: Cancer care beyond surgery
David L. Bartlett, MD
Director, David C. Koch Regional Perfusion Cancer Therapy Center
Regional perfusion is a technique where we isolate an organ or a region of the body and deliver chemotherapy to that organ or to that region of the body directly. So we use surgical tools to delivery chemotherapy.
We combine the chemotherapy with hyperthermia, or heat, in order to enhance the effects of chemotherapy and to directly kill cancer cells with heat.
We can isolate an organ like the liver, or we can treat a cavity like the abdominal cavity, and circulate chemotherapy through that organ, combined with heat, hyperthermia, at very high concentrations, high temperatures, and achieve a nice response of the tumor in that region without exposing the rest of the body to chemotherapy.
And so we can avoid the common side effects, like hair loss and suppression of the bone marrow, which leads to increased risk of infection and other side effects like nausea and vomiting, these kind of things.
An ideal patient is somebody that has regionally confined cancer, so the cancer is confined to the chest cavity, to the liver, to the abdominal cavity, to one of the legs or arms.
Enhancing Patient Confidence
I think our volume and experience with these procedures is what attracts patients here. We’ve been doing this for a long time and really have a high-volume program which enhances our overall effectiveness. And it’s not just the surgeons, but also the nursing care, the ICU management, the hospital, the operating rooms, everything is really geared up to perform these procedures.
The Koch Center is really set up as an educational tool for surgeons, as well as a research entity, so that we can enhance these treatments, and even bring new agents and even biologic agents into these regional perfusion approaches.
Innovative Treatment for Advanced Cancer
A lot of patients have run out of options; they’ve exhausted the standard treatment approaches for these disorders and they are looking for new hope.
I remember one young woman with metastases throughout her liver from colon cancer who was told that she really had no more options and this was a terminal stage of disease for her. She is somebody that we were able to put onto a clinical protocol, looking at a new drug delivered as an isolated perfusion of her liver, and we were able to basically hit the home run with her. We were able to eliminate all her disease and she’s four years out now with no evidence of disease. She has kids, she has a family. You know it’s just a thrilling result to take somebody that had no options.
We’re used to, and I think we’ve solved the problem of just removing cancers, but realizing that just removing it often isn’t enough. This is what I would consider as the next or cutting edge of surgical oncology — really using our tools and techniques to deliver the chemotherapy.
We are not curing everybody, but we have seen dramatic improvements in survival for all the types of perfusions that we do. And we see an increased response rate, in other words, the tumor is shrinking down as a result of these treatments where they wouldn’t otherwise.
For more information, contact us at 412-692-2852.