This procedure maximizes the response to the drugs while reducing the side effects experienced by the patients. Patients with disease limited to the arms or legs present a particular problem. Control of the disease can be very difficult. The Department of Surgical Oncology uses a procedure that is only available in limited sites called isolated perfusion. This is a technique that combines heat with high doses of chemotherapy delivered to the tumor sites while minimizing the amount of chemotherapy delivered to the rest of the body. This technique increases the response rate to the chemotherapy and can save the involved limb. It is often combined with other surgery and sometimes radiation therapy. The principles involved in the response have also been applied to the abdominal cavity. After undergoing excision of all the sites of cancer the abdominal cavity is bathed in a heated solution of chemotherapy. The abdomen does not absorb a large amount of the chemotherapy, allowing the use of high doses of chemotherapy. At the conclusion of the perfusion in both cases, the chemotherapy is washed out to limit the effect on the rest of the body.