Electrochemotherapy (ECT)

Electrochemotherapy (ECT) is a day procedure that is applied directly to your melanoma or skin tumour. It uses a dose of chemotherapy, quickly followed by electrical impulses

In ECT, chemotherapy is injected straight into the tumour. It isn’t common but sometimes we use intravenous chemotherapy, where chemo is delivered via a vein and travels through your body. Before the procedure, we inject a local anaesthetic to ensure comfort.

Within minutes of chemo delivery, we apply electrical impulses to the tumour. Small electrical impulses are delivered by a device that looks like a large pen. It only takes a few minutes to complete.

The electrical impulses make temporary holes in the membrane of the cancer cells. These holes allow the chemo deep into the cancer cells. Once there, chemo starts to work to slow and/or kill these abnormal cells.

In what setting is ECT done?

ECT can be done in either:

  • A clinic under a local anaesthetic (LA); or
  • An operating theatre under a general anaesthetic (GA).

Your doctor will discuss which anaesthetic option is best for you. Generally, GA is only required if you have a large tumour or multiple tumour sites.

If treated under a LA, you will be able to go home almost immediately. If under a GA, you

will need to stay under observation for a short period, the same as any other surgery.

Your doctor will discuss setting and anaesthetic options with you. Together you will decide which setting is most suitable for your needs.

How do you prepare for ECT?

You do not need to do anything unless you are having ECT under a GA. If having a GA, you will need to fast. You will receive fasting instructions before your treatment.

What are the side-effects of ECT?

Side effects of this procedure are minimal. You may get some mild pain or swelling around the injection site which can be managed with Paracetamol.

Stronger painkillers may be prescribed but only if this is needed.

Occasionally, treatment sites can become infected, and you may be given antibiotics.

The chemo drug can sometimes cause excessive pigmentation (skin colouring) around the site. This is uncommon but can be permanent.

In some rare cases, the chemo may cause lung scarring – if you have any existing lung problems, please alert your doctor.

What to expect after ECT?

The treatment site may have some minor bleeding or ooze for a few days after ECT. During this time, you should use simple, non-stick dressings to keep it covered. Non-stick dressings are easy to remove for showering and can be reapplied afterwards.

Often, the tumour site will develop a dry crust on the skin’s surface. This may last for several weeks before it falls off. Once dry, the wound does not need to be covered and can be left alone until the crust falls off and the skin beneath is healed.

Some more complex wounds or tumours may need a formal dressing/wound management plan. This will be organised before you leave hospital if required.

Contact

If you are a medical practitioner and would like to refer a patient for consideration of ECT, please contact This email address is being protected from spambots. You need JavaScript enabled to view it. or our lead ECT clinician, Dr Hayden Snow.