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PITTSBURGH (KDKA) — When a patient’s cancer comes back and spreads, doctors are now seeing it spread to the spine most often.
Treating a tumor in your spine is tricky, but there’s a new treatment that doctors say is working wonders.
Leo Wright has cancer of his jaw. One day he woke with concerning symptoms of it spreading to his spine.
“I couldn’t get out of bed,” he says, “I actually stood up and just almost fell, because my legs went straight out and my wife said, ‘What’s wrong?’ and I said, ‘It’s my back, I can’t move.'”
An MRI showed a fracture — his backbone had collapsed because of a tumor, a painful condition with few good treatment options.
“The spine is the most frequent location we’re seeing metastatic disease,” says Allegheny General Hospital neurosurgeon Dr. Nestor Tomycz.
Leo’s family was concerned.
“What if he can’t ever get out of bed again? And can’t ever walk again?” says his daughter, Lindsey Venditti.
“With his back, I really thought he was going to move to nursing care,” says Leo’s wife, Sandy Wright.
“Mets to the spine cause severe pain, disability, in severe cases can cause paralysis,” says Dr. Tomycz.
Leo didn’t want a big surgery to stabilize his spine with rods and screws, potential blood loss, a big incision and long recovery leading to missed cancer treatments. Then a neurosurgeon offered him something new, FDA approved in the last year — a type of bone cement.
“He said there’s this new surgery out where we put concrete in,” says Leo, “He said, ‘We’ve had great results with it.’ And I says, well, I know about the metal and stuff, and a lot of people told me not to go that way, so we’ll try this.”
The spine is a challenge because critical structures are packed into a small space.
With half inch incisions, and under x-ray guidance, the surgeons target precise areas with probes and 15-minutes of 200-degree heat.
“So we can kill the tumor with heat, but because the probes are cooled with water continuously, the area around is protected,” explains Dr. Tomycz.
Then they treat the fracture.
“We inflate balloons to treat the fracture and put cement in that area,” he says.
The procedure takes about an hour.
“From the patient’s stand point, they just have two puncture sites,” he adds.
There’s a risk of the cement getting into a vein and traveling to other parts of the body, also infection and bleeding, but these risks are less than one or two percent.
Of course, this doesn’t cure the cancer.
“The idea is to get these patients out of the hospital quicker, get them back to their home life and try to make this metastatic cancer more of a chronic disease that we can manage, since we can’t cure it,” says Dr. Tomycz.
And people are back to their day-to-day activities practically immediately — something you don’t see with open spine surgery.
“When he called me the next day and said, ‘Come get me,’ and I was like, ‘OK, are they going to wheel you out, or what?’ And he’s like, ‘No, we’re gonna walk. Come up to the room, and we’re going to walk down.’ And we did!” says Sandy.
“The fact that the incisions are so small, I mean, we really didn’t know what to expect. And the fact that he was up and moving the same day was very impressive, and with minimal pain,” says Lindsey.
In fact, his pain has gone from ten plus to zero.
“He just started moving so much better than he has in the last year,” Sandy says.
“I haven’t had one ounce of pain since it happened,” Leo says, “which I cannot believe.”