Isolated limb infusion localizes chemo, revolutionizes cancer treatment

Dr. Joette Giovinco reports

- Every three months, Mike Hladky comes to Tampa from Gillette, Wyoming for treatment at Moffitt Cancer Center. 

He's happy to make the long, frequent trips, considering where he began. Two years ago, after discovering a bump the size of half a golf ball on his right wrist, doctors in two other states recommended an above the elbow amputation. 

The bump was a sarcoma cancer, wrapping so tightly around his nerves, muscle and tendons, Hladky says he could hardly move his arm.

"Then, four days before [the amputation surgery] my doctor in Houston said, 'would you like to try isolated limb infusion in Tampa?' I said 'sure,'" Hladky told FOX 13's Dr. Jo.

While under anesthesia, the process begins with placing a tourniquet on the limb. 

"To start with, they take the blood out of your arm, reroute it for 45 minutes, and then heat your arm up, and then put hot chemo in there, and they can put it in an area where the cancer is," he explained.

He's had two infusions and says side effects are different from traditional chemotherapy. Hladky said there is some pain and a little sickness, and after each treatment he stays in the hospital for eight days. But isolated limb infusion localizes the chemo, so there is less chance of hair loss and other full-body effects.  

Surgical oncologist Dr. Jonathan Zager has been performing isolated limb infusion for eight years. 

"I've done about 50 limb infusions for sarcoma. We have a great response rate. About 50-percent of the patients are responding. A certain subset of the patients we downstage their tumor to respectable,"  Zager explained.

Dr. Zager is one of a few doctors in the country using the technique. Like Mike, about 80-percent of his patients don't live in the Bay Area. His youngest patient, age 16, had sarcoma in the leg, and at 95, his oldest had a merkel cell carcinoma in the arm. 

Dr. Zager has treated 200 patients over the past eight years, including some with melanoma and squamous cell carcinomas. 
He says the results are rewarding. 

"When I walk in the door and he's like, "I'm not telling him I have to take off your arm,' it makes both of us feel great," he smiled.

Hladky makes the trek to Tampa four times a year for scans and check-ups. 

"It's grown a little bit in some places and shrunk a little bit in some places," he says.  

It's a response that's allowing the basketball coach to keep his arm and stay in the game.

"If they hadn't come up with this procedure, I wouldn't have an arm, and you don't think about how important your limbs are until you're told you're gonna lose one," he said.

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