Orthopaedic Oncology: Growing Treatment Options for Adults and Children

Orthopaedic oncology is a relatively rare subspecialty—but not at Cooper. Three fellowship-trained orthopaedic oncologists are part of the Cooper Bone and Joint Institute and MD Anderson Cancer Center at Cooper, a testament to the exceptional depth of clinical expertise available here for adults and children with benign and malignant bone and soft tissue tumors.

“We’re the only orthopaedic oncology group in South Jersey, and we see the largest volume of orthopaedic oncology patients in the entire Delaware Valley,” says Tae Won Kim, MD, who co-directs Cooper’s Orthopaedic Oncology Center with the nationally renowned Richard D. Lackman, MD, FACS. More recently, attending orthopaedic oncologist Christina J. Gutowski, MD, MPH, joined the practice.

Recent advances in their field are notable.

“One of the major new diagnostic tools we’re using is genetic profiling—testing tumors for mutations to see if a targeted therapy is appropriate,” Dr. Kim says. “And we’re using more PET scans in staging and evaluating how tumors respond to chemotherapy.”

“Musculoskeletal imaging is enabling us to visualize tumors in a much more precise way, so we can more clearly elucidate what structures are involved and determine whether limb salvage is possible,” Dr. Gutowski adds, noting that with today’s techniques and technology, limb salvage is “more often than not an option over amputation for these tumors.”

When it comes to treating orthopaedic cancers, the options continue to expand and improve.

“We’re working with radiation oncologist Gregory J. Kubicek, MD, using CyberKnife® radiosurgery for treating soft-tissue sarcomas,” Dr. Kim says. “This allows us to deliver similar dose radiation in roughly one-third the time, so rather than five to six weeks of radiation therapy, patients can complete the treatment in two weeks.”

“We also have newer systemic and targeted treatments for both primary and metastatic disease,” Dr. Gutowski says. Plus, through its partnership with MD Anderson and participation in the Sarcoma Alliance for Research through Collaboration (SARC), Cooper is bringing national clinical trials to South Jersey to test novel chemotherapeutic agents.

On the surgical front, Cooper’s orthopaedic oncologists are using enhanced nutrition and post-op protocols to improve recovery after major sarcoma surgery, enrolling all surgical patients in specialized “prehab” and rehab programs. And they are investigating the role of bone transportation in reconstruction— transporting local bone to make up the defect caused by a tumor.

In addition, advanced implants and prostheses are improving postsurgical outcomes for both adults and children.

“New implants were recently FDA-approved for complex shoulder reconstruction after massive tumor resection,” says Dr. Gutowski, “and they’re proving more functional and durable for the long term.

“We also now have noninvasive ‘growing prostheses’ that allow for a child’s implant to grow like their limb normally would, so there’s no limb-length discrepancy after we remove a portion of a femur, for example,” she continues. “It’s really amazing.”

The foundation of the orthopaedic oncology group’s effectiveness is its collaborative, multi-disciplinary approach to care—one that places the patient at the center.

“We have an interdisciplinary tumor board conference that meets weekly to discuss individual patients,” Dr. Kim says. “It includes our team of orthopaedic oncologists as well as radiation oncologists, medical oncologists, musculoskeletal radiologists, and pathologists who are specially trained in these rare types of orthopaedic cancers.

“We treat all patients like our own family,” he continues. “We’d never make a recommendation to a patient that we wouldn’t make to a loved one.

“And we’re committed to working closely with referring physicians, keeping them in the loop about their patients,” he adds. “Our practice exists because we follow this model.”

For more information on Cooper’s orthopaedic oncology program, or to refer a patient, please call 856.361.1754.

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