Fighting Bone Cancer With Compassion and Expertise: Meet Orthopaedic Oncologist Dr. Herrick Siegel

What Sets Orthopaedic Oncologists Apart?

Orthopaedic oncologists like Dr. Siegel focus entirely on diagnosing and treating tumors of the muscles, joints, bones, nerves, and surrounding soft tissues. After completing medical school and an orthopaedic surgery residency, they pursue competitive specialized fellowship training in orthopaedic oncology. This intensive 1-2 year program at major cancer hospitals provides the in-depth knowledge needed to manage these rare and complex tumors.

Orthopaedic oncologists learn the intricacies of:

• Bone and soft tissue tumor biology and behavior
• Interpreting CT, MRI, and PET imaging studies
• Performing minimally invasive biopsies
• Developing chemotherapy and radiation therapy treatment plans
• Mastering complex reconstructive techniques after tumor removal

This comprehensive education enables them to accurately stage tumors, determine optimal treatment, carefully plan surgery, and reconstruct the skeleton after removing growths - all with the goal of eliminating cancer while maximizing limb function. Patients benefit from their refined expertise and ability to offer a tailored treatment approach.

Diagnosing Bone and Soft Tissue Tumors

The first step after an orthopaedic oncologist identifies a concerning mass is confirming the diagnosis through imaging and biopsy. This allows them to determine whether a tumor is malignant (cancerous), its exact type, and the appropriate course of action.

Advanced imaging techniques such as MRI and CT scans provide vital information about the tumor location, size, borders, and any spread to other sites. MRI is considered the gold standard for evaluating musculoskeletal tumors. Your oncologist will determine what imaging is needed for the best visualization.

A biopsy then follows, where a tissue sample is examined by a specialized pathologist. A core needle biopsy or incisional biopsy are common methods. The pathologist identifies if tumor cells are benign or cancerous, and defines the specifics if malignant.

For bone tumors, a benign (non-cancerous) diagnosis is more common than malignant. However, benign tumors can still lead to pain or fractures if left untreated. The most frequent malignant bone tumor in adults is osteosarcoma, typically affecting areas around the knee in adolescents.

In soft tissues like muscles, nerves, fat, and blood vessels, sarcomas are the main cancer type - accounting for about 1% of adult malignancies. Liposarcomas and undifferentiated pleomorphic sarcomas are most common. Soft tissue sarcomas often emerge in the thighs, arms, or trunk.

After a confirmed diagnosis, staging of the tumor follows. This helps guide the treatment approach. Staging takes into account tumor size, grade, location, lymph nodes status, and spread to distant sites like the lungs.

Treatment Options for Bone and Soft Tissue Tumors

Once Dr. Siegel has established the specifics of your tumor after thorough evaluation, he develops a customized treatment plan based on your unique circumstances. The main options include:

• Surgical Excision: Whenever feasible, limb-sparing surgery is performed to remove the entire tumor and surrounding tissue margins. Amputation may be needed if major blood vessels or nerves are involved.
• Radiation Therapy: Used before or after surgery, radiation helps decrease tumor size and lower recurrence risk. Newer techniques like proton beam therapy target tumors precisely.
• Chemotherapy: Powerful chemo drugs given before and after surgery attack remaining cancer cells. Neoadjuvant chemo can facilitate limb-sparing surgery.
• Advanced Targeted Therapies: For certain cancers unresponsive to standard chemo, newer immunotherapies and targeted drugs can prove beneficial.
• Cryosurgery: This technique uses extreme cold from liquid nitrogen to destroy some low grade tumors.
• Supportive Services: Physical and occupational therapy, nutrition support, counseling, and more aid the healing process.

Remarkable Progress in Treating Bone Cancer

Advances in orthopaedic oncology over the past decades have greatly improved outcomes for those with bone tumors. More limbs are spared, treatments are less invasive, and survival rates have risen.

Whereas amputation was once the norm, over 90% of patients' limbs can now be preserved. Dr. Siegel's excellent surgical skills and experience with complex reconstruction procedures allow him to resect tumors while maintaining optimal function.

He determines the ideal surgical approach based on tumor location and uses the following techniques:

• Limb-sparing: After removing the tumor, he reconstructs the bone defect with metal implants or bone grafts. Surrounding tissue may be repaired with muscle/tendon transfers.
• Curettage: He thoroughly scrapes out tumor tissue and fills the cavity with bone cement or grafting material. Cryotherapy helps kill leftover cells.
• Segmental resection: With tumors near joints, he must resect part of the bone and reconstruct it with a spacer implant. Knee or elbow replacement may be required.
• Amputation: Only done as a last resort today if major nerves/vessels are involved or the tumor cannot be eliminated otherwise.

With meticulous planning of margins using advanced MRI scans, Dr. Siegel is able to eradicate cancers while allowing patients to maintain limb function. This enhances quality of life after surgery.

His excellent skills have earned him an international reputation. He directs training courses for orthopaedic surgeons and serves as faculty for limb reconstruction programs worldwide. Patients come from across the country and globe for his expertise.

Excellence in Treating Metastatic Bone Disease

Unfortunately, cancer that originates in organs like the breast, lungs, thyroid, or kidneys can spread to bones. Managing metastatic bone disease presents challenges, as tumors may affect multiple regions. Patients often suffer debilitating pain and are at risk for fractures.

As an accomplished orthopaedic oncologist, Dr. Siegel has substantial experience stabilizing and reconstructing bones weakened by metastatic cancer. He performs surgery when radiation or medication do not adequately control pain or impending fractures.

His advanced techniques include:

• Metal implants - plates, rods, nails - to reinforce vulnerable bones
• Bone cement injection to support areas that have been damaged
• Joint replacement if cancer has destroyed the joints
• Amputation in cases with severe unremitting pain/nerve impingement

With today's improved systemic therapies, surgery, and radiation options, the functional status and longevity of those with metastatic disease has been enhanced. Dr. Siegel is dedicated to maximizing patients' quality of life however possible.

Comprehensive Care for the Best Possible Outcome

The most successful treatment for bone and soft tissue cancers involves an experienced, skilled orthopaedic oncologist leading a multidisciplinary team. Dr. Herrick Siegel fits this description perfectly. His compassionate nature, surgical mastery, and holistic approach increase the likelihood of cure.

No one wants to face cancer, but should you find yourself on this path, turn to Dr. Siegel for hope, healing, and the brightest future possible. With his guidance, you or your loved one will have the greatest chance of defeating sarcomas or metastatic disease while retaining maximal function.