Increased uptake of the chemotherapy drug impacts the cell DNA and results in cell-death. With destruction of tumour cells, the tumour regresses substantially. Along with it, treatment achieves good control of pain, bleeding and secretions from the tumour.

The currently commercially available electro-chemotherapy devices treat cutaneous and and sub-cutaneous tumours of any histology. The penetration of electro-chemotherapy electrodes is up to 20 mm. Tumours partially accessible with these electrodes can also be treated.

• Cancer types that can be treated with electro-chemotherapy:
• Head & neck squamous cell carcinoma
• Adenocarcinoma of the salivary gland
• Salivary gland hypernephroma
• Kaposi sarcoma
• Transitional cell carcinoma
• Basal cell carcinoma
• Squamous cell skin cancers
• Malignant melanoma
• Adenocarcinoma of breast

Head and neck cancer is a collective name given to various types of cancers in the head and neck region. 90% of the head and neck cancers are squamous cell carcinomas. 10% of head and neck cancers are adenocarcinomas, lymphomas, metastatic legions and skin cancers in the head and neck region.

Head and neck cancers which can be treated with electro-chemotherapy:

Squamous cell carcinomas of the head and neck region:
• Oral cavity cancers (cancer of lips, gums, tongue, cheeks, roof or floor of the mouth)
• Pharyngeal cancers (naso-pharyngeal cancer, oro-pharyngeal cancer, hypo-pharyngeal cancer)
• Laryngeal cancer
• Nasal cavity cancer
• Paranasal sinuses cancer

Adenocarcinoma in the head and neck region:
• Salivary glands cancer

Metastatic legions in head and neck region:
• Kaposi sarcoma
• Salivary gland hypernephroma
• Transitional carcinoma

Skin carcinoma in the head and neck region:
• Basal cell carcinoma
• Malignant melanoma

Adenocarcinoma is the most common type of breast cancer. Electro-chemotherapy can be used for breast adenocarcinomas. It can be used for palliative care and adjuvant, neo-adjuvant treatment of breast adenocarcinomas.

Electro-chemotherapy is recommended as a palliative tool for the treatment of cutaneous and subcutaneous metastases and recurrence of breast cancer.

There are three types of skin cancers:
• Basal cell carcinoma
• Squamous cell carcinoma
• Malignant melanoma

Electro-chemotherapy can be used for treatment of all three types of skin cancers. It can also be used with curative intent in basal cell carcinomas. Electro-chemothrapy can be used for treating actinic keratoses, the pre-cancerous growth of squamous cell carcinomas.

Electro-chemotherapy with bleomycin has also been used in treatment of large keloids or hypertrophic scars. Both these types are benign occurrences.

Electro-chemotherapy is recommended as:

Neo-adjuvant treatment: to reduce tumour size prior to surgery; thus enable/facilitate surgery of large tumours.

Adjuvant treatment: Along with chemotherapy and/or radiation therapy for better tumour specific results.

Palliative care: For tumour size reduction and control of tumour pain, bleeding and secretions to ease trauma and inconvenience.

Number of impulses depend on the size of the tumour. It is essential to cover the entire tumour with impulses.

Time needed for the procedure:
Electro-chemotherapy is usually a short procedure. In most cases it is done under local anesthesia and requires around 30 minutes. It is a day procedure and patient can go home after an observation period of 2 /3 hours. However, in some cases, doctor may decide to do it under general anesthesia. In that case, procedure will take a little longer and in-patient hospital admission will be required.

Time period to see the impact: First signs of improvement are seen in about 48 hours. Early relief is in the form of reduction in tumour pain, bleeding and secretions. Tumour regression is seen in about 2 to 4 weeks. In large tumours it can take up to 10 weeks to see the complete impact.

Quantity of drug required in electro-chemotherapy is fairly small. Hence side-effects are minor or nil. The electric impulses cause no or little side-effects.

A few probable side-effects include fever due to intravenous injection of bleomycin and small local pain and redness. These can be treated with routine treatment measures. Doctor may prescribe antibiotics to avoid post-procedural infection. In case of general anaesthesia, any vomiting in sensitive patients can be managed with standard regimens for the problem.

Yes, multiple sittings can be done. Usually response is seen in one or two sittings. For larger tumours (tumours larger than 1 to 1.5 cm3 ), two or more sittings may be needed