Cancer rarely starts in the spine on its own. Most spinal tumors come from breast, lung or prostate cancers that have metastasized, or spread, from their original tumor sites.
Yet for some reason the spine is one of the most common locations where cancer spreads. In fact, one in four cancer patients will have a tumor that metastasizes to the spinal column. This is particularly distressing due to the threat of spinal cord injury and the excruciating pain that can arise.
|Mike Chen (Photo by p.cunningham)|
To treat this condition, surgeons often remove tumors as well as the bone surrounding the tumor area from the spinal column. This usually requires reconstruction of the spine, an extremely complex procedure. Surgeons must use a combination of metal devices, bone cement and bone grafts to keep the back stabile.
But City of Hope neurosurgeons Rahul Jandial, M.D., Ph.D., and Mike Y. Chen, M.D., Ph.D., who co-direct the institution’s spinal cancer program, are searching for better answers.
“We are taking the fundamentals of stem cell biology and extending them to regenerative medicine for reconstructing the spinal column,” said Jandial, assistant professor of surgery in the Division of Neurosurgery.
Chen, assistant professor of surgery, noted that patients with cancer are living longer and physicians must consider how to keep them active and protect quality of life. As survival increases, he said, “we want to be the leading edge in medical, scientific and surgical innovation for keeping our patients free of suffering and as highly functional as possible.”
|Rahul Jandial (Courtesy of Rahul Jandial)|
While current spinal reconstruction depends on metal devices, the duo is interested in finding methods to coax natural bone growth for repairs, Chen said.
The physician-researchers believe stem cells could play a dual role: They could help renew bone and, in the near future, deliver therapies that can kill tumors at the same time.
Jandial and Chen are studying adult mesenchymal stem cells, which can develop into bone, cartilage and fat cells. These stem cells have the potential to produce bone-promoting proteins. Scientists hope to create a therapy that will encourage diseased areas of the spine to regenerate healthy tissue. New, disease-free bone cells would grow on the scaffold of the spine much like vines growing on a trellis.
The pair’s research will focus on basic lab studies they hope will ultimately benefit spinal cancer patients who need extensive tumor removal followed by repair. Their ultimate goal: Keep these patients independent and free from neurological injury.