Cancer-ravaged bone can be ‘tricked’ into regenerating
When I was a student at Yale University School of Medicine in the early 2000s, one of my professor-mentors introduced me to the concept of bone regeneration. I hadn’t known it was possible for the body to heal and regenerate itself to such an extent, and I found it absolutely fascinating!
High-grade bone cancers used to be a death sentence. If a person was lucky, he would get a limb amputated and live a few more years. Then chemotherapy came along and suddenly 70 percent of younger patients with these aggressive bone cancers were surviving.
Doctors could now treat the cancer with chemo, remove the tumors, and replace the bone defect with metal implants. However, metal things tend to break and wear out. As people got older, they needed multiple surgical interventions to fix or replace the implants. That meant hospital stays, risk of complications, sometimes infection.
Instead of medical implants, what if we could use the body’s natural ability to regenerate bone?I couldn’t wait to tell my mentor.
“It is a great idea,” he said. “But not a new idea.”
Turns out a professor in Japan had been exploring this idea for 25 years already. Still, my mentor assured me, it was a good idea and there was room to explore and expand on it.
I was fortunate in 2014 to be recruited onto the team at the Memorial Sloan Kettering Cancer Center, and we began to explore the possibilities of bone regeneration. I’m excited to say the research and clinic trials we are doing are game-changing, especially for younger people with bone cancer.
Essentially, we are helping the patient’s body heal itself. We trick the body into thinking there’s a fracture, and we can slowly but surely use the fracture healing response to make new bone to seal the gap where the tumor was removed. In this way we can avoid the need for metal implants and help people grow back their own bone. And—most importantly— we can set up a young person for a much better quality of life for a longer period of time than ever before. As of now, Memorial Sloan Kettering is the only place in the U.S. using this limb-lengthening technique, but I hope it won’t be long before others follow suit.
In 2018, I was honored with a Service Excellence Award from Healthnetwork Foundation to support research in the field of bone regeneration in patients affected by bone cancers. Our research focus is to better understand the process of distraction osteogenesis to optimize bone healing for each individual. Those who support Healthnetwork should know this kind of funding is important in getting a project like this started. We often use such funding to hire researchers or grad students, helping launch a project in the early stages; then, we can turn it into much bigger things.
DANIEL E. PRINCE, MD, MPH is a surgeon specializing in orthopedics and musculoskeletal oncology at Memorial Sloan Kettering Cancer Center in New York. He created their bone regeneration team which focuses on limb- and joint-sparing reconstructive techniques to optimize patients’ function and quality of life.