Electrochemotherapy represents an innovative approach in cancer treatment, combining the established power of chemotherapy with precisely delivered electrical pulses. This multidisciplinary therapy aims to enhance the effectiveness of anti-cancer drugs directly within tumor cells. It offers a targeted strategy for managing certain types of localized cancers.
Understanding Electrochemotherapy
Electrochemotherapy operates on the principle of electroporation, a process that temporarily increases the permeability of cell membranes. During this procedure, a chemotherapy drug, often bleomycin or cisplatin, is administered to the patient, either intravenously or directly into the tumor. These drugs are not easily absorbed by cancer cells under normal conditions.
Following drug administration, short, intense electrical pulses are delivered to the tumor site using a specialized probe with electrodes. These electrical pulses create tiny, temporary pores or “nanopores” in the outer membrane of the cancer cells. This transient permeabilization allows a significantly greater amount of the chemotherapy drug to enter the cancer cells, enhancing its cytotoxic effect. Beyond direct drug uptake, the electrical pulses also affect the tumor’s blood vessels, causing temporary vasoconstriction that reduces blood flow and helps to concentrate the drug within the tumor, creating a “vascular-lock” effect.
Treating Cancer with Electrochemotherapy
Electrochemotherapy is primarily utilized for localized tumors, particularly those affecting the skin or just beneath its surface. This includes primary skin cancers such as basal cell carcinoma and squamous cell carcinoma. It is also commonly employed for skin metastases, which are cancers that have spread to the skin from other parts of the body.
Common examples of skin metastases treated with electrochemotherapy include those originating from melanoma, breast cancer, head and neck cancers, and Kaposi’s sarcoma. While primarily used for accessible skin tumors, research explores its use for internal tumors reachable through endoscopic or surgical approaches, such as those in the liver or pancreas. The treatment can help control symptoms like bleeding and pain associated with these tumors.
Advantages and Patient Experience
An advantage of electrochemotherapy is its targeted nature, which allows for lower doses of chemotherapy drugs compared to systemic chemotherapy, thereby reducing systemic side effects. This targeted delivery helps preserve healthy surrounding tissue while concentrating the drug’s effect within the tumor. The procedure is considered minimally invasive and can be repeated if necessary to achieve tumor control.
Patients undergo electrochemotherapy as an outpatient procedure, returning home the same day. Depending on the size and number of areas treated, a local or general anesthetic may be administered. During the procedure, muscle contractions or twitching may occur due to the electrical pulses, but these cease once the treatment is complete. Following treatment, patients may experience localized pain, swelling, and bruising in the treated area, which are mild and resolve within a few days to weeks. Mild nausea or flu-like symptoms can also occur, but serious side effects are uncommon.
Who Can Receive Electrochemotherapy?
Electrochemotherapy is considered for specific patient profiles, particularly when other treatments are not feasible, have failed, or when the disease is localized and accessible. Patient suitability is determined through a comprehensive assessment by a multidisciplinary medical team.
While effective for many, it is not universally applicable. Certain conditions may preclude its use, including severe bleeding disorders, an allergy to the specific chemotherapy drug used, or pre-existing conditions such as poor renal function or pulmonary fibrosis. Patients with certain cardiac conditions, like ventricular arrhythmias or uncontrolled epilepsy, also require careful evaluation.