Advocate Illinois Masonic Medical Center Brings Limb-saving Innovation to Patients with Advanced Melanoma

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Advocate Illinois Masonic Medical Center was the site of a first-of-its-kind procedure in Chicago for an advanced melanoma treatment called Isolated Limb Infusion (ILI). Ajay V. Maker, MD, director of surgical oncology for the hospital's Angelo P. Creticos, MD, Cancer Center, led the team that performed this unique treatment recently for a grateful patient. ILI isolates strong chemotherapy treatment to the affected limb, greatly limiting exposure to the rest of the body. The first procedure was a great success, reducing multiple malignant lesions significantly and with several disappearing completely.

(Anneliese) showed an objective clinical response by our most stringent criteria, with all of her tumors having shrunk considerably and with some of her tumors completely disappearing.

Anneliese Nitzschke first underwent treatment for melanoma on her left leg 31 years ago, only to have the condition recur in multiple areas of her leg in 2009 and again in 2011. The disease was spreading and she was running out of options.

“Back then, they cut it out, you know, just removed pieces of my leg,” Nitzschke, 74, said. “When it came back again, I didn’t want to lose my leg. I was so afraid of that.”

Instead of the surgical procedures she’d undergone in the past, where cancerous tissue was removed along with a good amount of surrounding healthy tissue, Nitzschke found her way to Advocate Illinois Masonic Medical Center, where she was determined to be the ideal candidate for the first procedure of its kind in Chicago—isolated limb infusion, or ILI.

The innovative procedure was brought to Chicago by Ajay V. Maker, MD, director of Surgical Oncology at Illinois Masonic’s Angelo P. Creticos, MD, Cancer Center, and assistant professor in the Division of Surgical Oncology at the University of Illinois at Chicago.

“Anneliese had multiple melanomas located throughout her leg and when I met her, they were increasing in number,” Maker said. “To do nothing could very well have led to the loss of her leg. We discussed her case, and felt that a new treatment that could isolate treatment just to her leg would be her best option and have the least side effects on the rest of her body.”

Maker was trained in both ILI and isolated limb perfusion (ILP) during his time at the NIH’s National Cancer Institute and New York’s Memorial Sloan-Kettering Cancer Center. He found Nitzschke to be the perfect candidate for ILI and led the team that performed her procedure earlier in 2011.

“Though melanoma can recur years after initial diagnosis, as in Anneliese’s case, it may spread in the limb without going to other areas of the body,” Maker said.

This localization allows for the effectiveness of ILI, which delivers strong, heated chemotherapy treatment to only the affected limb, leaving the rest of the body unexposed to the toxicity of the chemotherapy. A tourniquet cuts the blood supply from the body and the treatment is circulated only in the affected limb. The drugs are then flushed from the leg prior to reestablishing blood flow. The treatment takes about 30 minutes and the whole procedure can be completed in a few hours, Maker said, and may allow the patient to avoid systemic chemotherapy or further surgery. The patient is typically observed closely for a few days after the procedure to monitor for any side effects. The procedure is only offered at a few specialized centers around the world.

Nitzschke responded remarkably well. She was watched closely in the hospital for a few days after the procedure and had no side effects. “She showed an objective clinical response by our most stringent criteria, with all of her tumors having shrunk considerably and with some of her tumors completely disappearing,” Maker said.

Six months after the procedure, Nitzschke’s melanomas continued to shrink after just the one treatment. “The procedure can be repeated if necessary, but she’s still continuing to responding nicely to the initial treatment,” he said.

“I’m so happy, I think about it every day,” Nitzschke said. “I can walk and stay active. I hope this can help a lot more people.”

For further information on melanoma treatments and this procedure, appointments can be made with Maker and the team by calling 800.3.ADVOCATE (800.323.8622) or logging onto http://www.advocatehealth.com/masonic.

About Advocate Illinois Masonic Medical Center
Advocate Illinois Masonic Medical Center is a 408-bed hospital in Chicago with a Level I trauma center and a Level III Neonatal Intensive Care Unit, the highest designations awarded by the state of Illinois. It offers comprehensive inpatient services, including medical, surgical, obstetrics and pediatric care, as well as a full breadth of outpatient services. A recipient of numerous awards for quality and clinical excellence, Illinois Masonic was ranked one of the nation’s 100 Top Hospitals in 2010 and 2011 by Thomson Reuters, as well as named a recipient of the organization’s Everest Award for National Benchmarks in 2010. The medical center also was named a Top Performer in the Human Rights Campaign’s Healthcare Equality Index, as well as one of the 50 Best Hospitals in America by Becker’s Hospital Review for 2010. In 2008, the hospital achieved Magnet designation for excellence and quality in nursing services by the American Nurses Credentialing Center’s Magnet Recognition Program. Illinois Masonic is part of Advocate Health Care, a 2009 and 2010 Thomson Reuters Top 10 U.S. health care system for quality and clinical performance and the largest provider of health care services in Illinois. For more on Illinois Masonic, visit advocatehealth.com/masonic.

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