Montefiore Einstein Center For Cancer Care Is the first facility In Northeast three types of regional chemotherapy treatments

Montefiore Einstein Center for Cancer Care is the first facility in the Northeast three types of "regional" chemotherapy treatments for cancer patients that go beyond standard surgical removal but confined to a body or a region of the body. Regional perfusion therapy isolates the abdominal cavity or the circulatory blood in the arms, legs or liver and then delivers a concentrated dose of anti-cancer drugs to the targeted area of the body at levels higher than can be safely given intravenously, avoiding the side effects of standard chemotherapy and improving the effectiveness of the treatment. Montefiore Medical Center has put together an expert, coordinated team of surgeons, nurses, perfusionists and anesthesiologists, this unique approach to cancer patients.

"Regional perfusion therapy can find the perfect balance between maximizing the dosage of a drug and minimizing toxicity to the patient," said Steven k. Libutti, MD, Director, Montefiore Einstein Center for Cancer Care. "We are the first center in the northeast to offer three highly effective types of perfusion therapy for critically ill patients." Dr. Libutti performed approximately 200 liver perfusions and 200 peritoneal (belly) perfusions at the National Cancer Institute before coming to Montefiore.

Peritoneal cancers

For patients with advanced cancer of the Appendix, colon and stomach, that adhere to the lining of the peritoneal Cavity have spread, offers Montefiore Einstein Center for Cancer Care is a very specialized treatment HIPEC (hyperthermic intraperitoneal chemotherapy). This procedure involves the removal of tumors in the abdomen by surgical resection followed by the delivery of high doses of heated chemotherapy in the peritoneal cavity for up to 90 minutes while the patient is still in the operating room. After the highly toxic drug peritoneal cancer cells to destroy, they are crops from the cavity.

"We surgically remove any visible organ tumors; perfuse the peritoneal cavity with high doses of mitomycin C, a powerful anti-cancer drug that any remaining cancer cells in the cavity kills. The approach has proved highly effective for the six patients who we dealt with in the past year were, "explains Timothy Kennedy, MD, surgical oncologist to Montefiore, specialising in gastro-intestinal disease and carried out six HIPEC procedures at Montefiore in the past year with Dr. Libutti."

Isolated limb perfusion for melanoma and Sarcomas

Patients who have advanced melanoma, or have soft-tissue sarcomas in the legs or arms that cannot be surgically removed can be treated with isolated limb perfusion at Montefiore Einstein Center for Cancer Care. It is the only type of treatment available, save amputation, for many of these patients.

A tourniquet is used for the insulation of the leg or arm's blood circulatory system; then is a highly toxic drug, melphalan, in this closed loop of arteries and veins.

"Melanoma is very resistant to standard, systemic chemotherapy. For patients with melanoma that has been isolated to an arm or a leg, perfusion therapy is their best option. In these cases, complete remission rates for melanoma treated by isolated limb perfusion more than 60 percent, "said Katia Papalezova, MD, a surgical oncologist to Montefiore, specializing in melanoma and sarcomas, as well as isolated limb perfusion. Recently, they treated a patient with a recurring Sarcoma whose options an above-the-knee amputation or were isolated limb perfusion. Dr. Papalezova administered titration with excellent results. "In our three-month follow-up of the patient, the Sarcoma is gone," she said.

High-dose treatment of liver tumors

Montefiore Einstein Center for Cancer Care also offers patients liver perfusions, a chemotherapy treatment that the liver blood circulatory system isolates and then manages the drug, melphalan, liver tumors shrink. The approach can be used for the treatment of primary tumors of the liver such as hepatocellular carcinoma, or for the treatment of tumors that have spread to the liver such as colon cancer and Neuroendocrine tumors of the pancreas. That are no longer candidates for surgical resection or whose tumors have grown despite systemic chemotherapy patients may be eligible. Tumours respond to this type of therapy in a whopping 75% of the patients. These procedures are carried out by Dr. Libutti, Milan Kinkhabwala, MD, Chief, Division of transplantation and Sarah Belle mare, MD.

Source: Montefiore Medical Center