Cancer rarely starts out growing in the spine — but the spine is one of the most common places to find the disease. That is because many malignancies, such as breast, lung and prostate cancers, tend to spread there.

One in four cancer patients will have a tumor that metastasizes to the spinal column, potentially injuring the spinal cord and causing excruciating pain. To treat this condition, surgeons often remove the tumor and surrounding bone.

But spinal reconstruction after tumor removal is complex, requiring a combination of metal devices, bone cement and bone grafts to stabilize the back. City of Hope neurosurgeons Rahul Jandial, M.D., Ph.D., and Mike Y. Chen, M.D., Ph.D., are searching for better answers.

Jandial and Chen, co-directors of City of Hope’s spinal cancer program, were awarded a two-year, $750,000 grant to research stem cells to help rebuild the spine after removing destructive spinal tumors. The research grant is sponsored by NuVasive Inc., a San Diego-based medical device company focused on spinal disorders.

“We are taking the fundamentals of stem cell biology and extending it 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, “Current spinal reconstruction depends on metal devices to retrofit the spinal column, but we’re interested in finding methods to induce natural bone growth for repairs. These stem cells will not only help regenerate bone, but will hopefully in the near future also deliver therapeutics that can kill tumors at the same time.”

Through the grant, Jandial and Chen are evaluating adult mesenchymal stem cells — which can differentiate into bone, cartilage and fat cells — for their potential to express 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 molecular and cellular basic science investigations in the laboratory, intending ultimately to benefit spinal cancer patients who need extensive tumor removal followed by a durable repair to keep them independent and free from neurological injury.

The project grew from the multidisciplinary nature of City of Hope’s spinal cancer program. The program draws from diverse research and treatment expertise within surgery, neuroradiology and other specialties, as well as basic science.