Investigating a new joint approach to treating metastatic bone disease

  • Research type

    Research Study

  • Full title

    Investigating a new joint approach to treating metastatic bone disease: radiotherapy first?

  • IRAS ID

    255203

  • Contact name

    Anna H K Riemen

  • Contact email

    ariemen@abdn.ac.uk

  • Sponsor organisation

    University of Aberdeen/NHS Grampian; Research Governance Office

  • Duration of Study in the UK

    1 years, 0 months, 1 days

  • Research summary

    Cancer that has spread to the lower limb long bones weakens the bone resulting in fractures without a preceding injury (pathological fractures). The pain and subsequent inability to use the affected limb, is treated by inserting a metal rod into the bone to make it solid. Once the surgical wounds have healed and the risk of wound infection has passed, radiotherapy is used to kill the rapidly dividing cells which are the cancer cells present within in the affected bone. The normal cells that heal the cuts resulting from surgery are also rapidly dividing and are therefore also killed by radiotherapy. For this reason, surgery has traditionally been performed before radiotherapy and a sufficient period of time is allocated to permit the wounds to heal adequately to avoid potential serious complications from giving radiotherapy prior to surgery such as slow or non-healing wounds that can result in wound infections, and the bone failing to heal.

    However, surgery could push cancer cells into the blood stream allowing them to spread to other areas of the body. Furthermore, the release of cancer cells could cause acute and serious injury to the lungs.
    Due to surgical advances that could permit radiotherapy to be administered before surgery, the risks of cancer spread and acute lung injury could be reduced.
    Using non-invasive ultrasound scans, we will assess the extent and timing of cancer cell release into the bloodstream during surgery, and observe any subsequent deterioration in the patient’s heart and lung function. This information will be used to determine the best time to take limited blood samples to catch the cancer cells within the bloodstream and to analyse them further in the laboratory.

  • REC name

    East Midlands - Derby Research Ethics Committee

  • REC reference

    20/EM/0004

  • Date of REC Opinion

    28 Feb 2020

  • REC opinion

    Further Information Favourable Opinion