Boning Up on Metastatic Disease
New Musculoskeletal Oncology Services Benefit Breast Cancer Patients
X-ray image of a tumor prosthesis used to replace the hip and part of the upper thigh bone for an aggressive breast cancer in this part of the body.
Breast cancer is the most common site of origin for metastatic disease, or the spread of the disease to the skeleton — most commonly to the spine, pelvis or long bones. Moreover, bone is the most common site of recurrence for breast cancer. With the addition of musculoskeletal oncologist Jason Weisstein, MD, MPH, FACS to the staff of Eisenhower Desert Orthopedic Center, these patients can now receive their entire treatment at Eisenhower Medical Center.
“It is a very positive thing for patients to be treated within one health system. Studies have shown that optimal treatment of patients happens better in a multidisciplinary setting, and we can now offer the radiation care, the medical oncology care, and the surgical oncology care for patients who have musculoskeletal complications of cancer,” says Dr. Weisstein.
Formerly co-director of the bone and soft tissue tumor service at the University of Washington, Dr. Weisstein specializes in the surgical care of patients with benign and malignant bone and soft tissue tumors. He is the only orthopedic oncology subspecialist in the Valley. “The most common type of patient I see is one whose cancer has spread from a primary site and then affects the skeleton. Many of my patients are young women with aggressive breast cancer who present with an ache in a bone or a fracture.”
“Cells can travel through the body causing new tumors in individuals with advanced breast cancer. This process is called metastatic disease and commonly results in a compromised bone.”
According to Dr. Weisstein, cells can travel through the body causing new tumors in individuals with advanced breast cancer. This process is called metastatic disease and commonly results in a compromised bone. “The cancer then nibbles at the walls of the bone, weakening its structure,” says Dr. Weisstein.
While this condition is serious, Dr. Weisstein notes there are many treatments available to women. “The situation may warrant further chemotherapy or a clinical trial. Treatment options are based on a patient’s age, their cancer subtype, whether their hormone receptor is positive or negative, and if they are positive for the BRCA [breast cancer susceptibility] gene — all of these are important factors for determining appropriate treatment and a prognosis.”
A patient who is symptomatic is often treated with radiation therapy, chemotherapy, surgery or any combination of the three. Surgery involves reconstruction with metal rods, plates or artificial joints. “We are always prepared for the worst case scenario. We have plan A, B and C ready — everything from plates, rods and screws, to bone transplants, to replacement of the bone with metal constructs, artificial hips, and artificial femurs.”
A native Southern Californian, Dr. Weisstein is grateful for the opportunity to merge both of his passions — limb salvage and joint reconstruction. “It is wonderful to work at Eisenhower, which has such an outstanding reputation for orthopedics, and to work in an environment that has state-of-the-art radiation oncology treatments and diagnostic imaging in the form of the most advanced CT, MRI and PET scanners, all of which make the diagnosis and treatment of these patients much easier.”