Thomas Parker Vail, M.D., describes the collaborations that are key to the success of the musculoskeletal oncology program. The team approach includes surgeons, specialized nurses, medical oncologists, radiation oncologists, radiologists and pathologists. Many are pioneers who have performed numerous procedures rarely seen in other hospitals.
UCSF is a leader in compressive osseointegration, a technique in which a spring-loaded implant applies hundreds of pounds of pressure to hold an "anchor plug" in the remaining bone. The technique may offer a better quality of life than traditional limb salvage surgery without increasing the risk of complication.
UCSF research is leading to ways to identify patterns of spinal involvement that indicate high risk of fracture and paralysis, and that therefore justify more invasive treatment of primary and metastatic bone cancers. Experience in vertebroplasty and kyphoplasty can help surgeons shore up the spine, relieve pain and prevent bony collapse. Clinical researchers are testing promising phototherapy, and using imaging and bone modeling to guide unique reconstructions.
To obtain the most accurate diagnosis and prognosis in evaluating bone sarcomas, it is important to have a radiologist on the team.
Tissue sarcomas are extraordinarily heterogeneous. Some cases may be treated effectively with chemotherapy in conjunction with surgery and radiation. Intraoperative radiation therapy (IORT) may be considered to reduce or prevent complications associated with pre- and postoperative radiation, to ensure a clear field with optimized margins, and to reduce the field for postoperative dosing.
Evaluation of a 47-year-old man, referred to UCSF for a suspected hematoma following mitral valve replacement, led to diagnosis of a grade 2 myxoid round cell liposarcoma. The cancer grew despite surgery and intraoperative radiation therapy. Subsequent treatment with radiation and six rounds of chemotherapy — with care taken to avoid cardiac toxicity — eliminated the tumor. The patient remains disease-free.
At the UCSF Imaging Center at China Basin, in most cases, a radiologist can interpret a scan and return results to the referring physician within 24 to 48 hours.
Information on upcoming continuing medical education courses is available online.
The UCSF Physician Liaison Service provides assistance and information to referring physicians, medical groups and health plans. Please call the Physician Liaison Service or visit www.ucsfhealth.org/health_professionals/make_a_referral/.
Phone: (800) 444-2559
Fax: (415) 353-4395
The UCSF Transfer Center is open 24 hours daily to coordinate the transfer of your patients to UCSF Medical Center from hospitals throughout the region.
Phone: (415) 353-9166
Fax: (415) 353-9172