Electrochemotherapy for cancers affecting the skin

Electrochemotherapy is a treatment that combines chemotherapy with a small electrical current. Doctors use electrochemotherapy to treat cancers that:

• started in the skin
• started elsewhere in the body and have spread to the skin

What is electrochemotherapy?

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. Electrochemotherapy is a way of getting chemotherapy into cancer cells.

It is a combination of:

• chemotherapy injected into the tumour or bloodstream
• an electric pulse to send the chemotherapy into the cancer cells (called electroporation)

A special probe sends an electric pulse to the tumour. The electric pulse changes the outer layer of the cancer cell. This makes it easier for the chemotherapy to get inside the cell.

Who can have electrochemotherapy?

Doctors use electrochemotherapy for cancers that started in the skin. Or cancers that have spread to the skin from elsewhere. These include:

• basal and squamous cell skin cancers
• melanoma skin cancer
• Kaposi’s sarcoma
• breast cancer that has spread to the skin
• head and neck cancers that have spread to the skin

The National Institute for Health and Care Excellence (NICE) have approved electrochemotherapy. It is a treatment to relieve symptoms for people with cancers affecting their skin. It can help to control symptoms when other treatments are no longer working. 

Most people who have this treatment have some improvement in their symptoms. How much it it helps varies from one person to another. You might need more than one treatment to control your symptoms.

Research is looking into finding out more about how well it works and which patients it can help.

How you have electrochemotherapy

You usually have electrochemotherapy as a day patient. But occasionally people need to stay in hospital overnight. You have a general anaesthetic, so you are asleep. Or you might have a local anaesthetic with a drug to make you sleepy (sedation). 

You have chemotherapy as either:

• an injection into the tumour (intratumoural)

• an injection into your bloodstream through a small tube (intravenously)

There are different types of chemotherapy drugs. You might have a chemotherapy drug called cisplatin or bleomycin. You have a lower dose than with standard chemotherapy treatment. This is because the electric pulse helps the chemotherapy get through the cell wall. Lower doses of chemotherapy mean fewer side effects.

Injection into the tumour

You might have this treatment awake with a local anaesthetic to numb the area. Or you might be asleep (general anaesthetic).

First you have an injection of local anaesthetic to numb the area. The doctor then injects the chemotherapy. You have the electric pulse immediately afterwards.

Injection into a vein

You usually need to have this while you are asleep, under general anaesthetic.

You have the chemotherapy into a vein. Then eight minutes later, you have the electric pulse to the tumour.

The electric pulse comes from a special machine. Attached to the machine is a probe. The probe is the size of a large pen and has an electrode on it. The doctor puts the electrode against your skin to deliver an electric pulse to the tumour.

Your treatment can take between 10 and 60 minutes, depending on how many tumours you have.

Side effects of electrochemotherapy

Pain

The main side effect is pain in the area where the electrode touches the skin. This is usually mild and lasts for a couple of days. More rarely some people have more severe pain that can last between two and four weeks. Your doctor or clinical nurse specialist will give you some painkillers if you need them. 

Muscle contractions

Some people have muscle contractions during the treatment. Your doctor can slightly alter the way they give treatment if this is uncomfortable.

Feeling sick

You might feel sick but this is usually mild and you can have anti sickness medicines.

Infection

Infection in the area you have treatment is rare. Tell your doctor if you notice the area has become redder, swollen, painful or if there is any discharge. 

Changes to skin colour

You might notice the colour of your skin changes where you had treatment. It might be darker or lighter. This usually fades with time but can be permanent for some people.

Skin breakdown

The area where you have treatment can form an ulcer or the skin might breakdown. If this happens you will need a nurse to dress it until it heals. This might take a couple of weeks.  

Research into electrochemotherapy

Researchers want to find out how well electrochemotherapy works for different types of cancers. And they are looking at ways to improve how well it works. Research includes:

• electrochemotherapy as a treatment for cancers deeper inside the body - for example cancers that have spread to the bone or liver
• combining electrochemotherapy with other treatments, such as surgery
• combining an electrical current with different types of drugs such as immunotherapy

Where can I get electrochemotherapy treatment?

Electrochemotherapy is a newer treatment for symptoms of cancer of the skin. It is available in some hospitals in the UK.

It might not be available at your closest hospital and you may need to travel to another hospital to have it. Talk to your doctor if you are interested in having this treatment. They can tell you if it is suitable for you and if it’s available in your area.

Information about your cancer type

We also have information about different cancer types and their treatments, and information about support and coping.