Public health crisis
Approximately 2 million people are living with cancer in the UK and this number is set to rise considerably over the next decade to 3.2M. A significant complication of late stage (stage 4) cancer is metastases or secondary tumours which are caused by tumour cells spreading to different locations in the body.
Metastases are particularly associated with breast cancer, which is the most common cancer in females and the leading cause of cancer deaths in this group. According to Cancer Research UK, 150 people every day are diagnosed with breast cancer. Although more than 76% of people with the disease survive for more than ten years, some patients do develop stage 4 cancers, of which it is estimated about 50% to 60% get bone tumours.
The tumours weaken the bone and lead to a variety of problems for the patients at a time when quality of life is a paramount consideration, especially as the prognosis is usually terminal.
Significant issues include severe pain and spinal fracture which may lead to spinal cord injury. These complications often require major surgery which encroaches, significantly, on the patients’ quality of life, when life expectancy is a matter of months and may, in certain cases, provide a mechanism of further spread of the cancer. Currently, there are no implants for supporting the bones before fracture as we cannot identify which vertebrae are likely to fail.
A more patient-friendly approach is realised in OncoEng in which we predict which vertebrae with tumours are likely to fail in the future enabling informed decision on care.
The Technology
Advanced computational modelling and imaging will be used to look at the growth of the tumour so that predictions of the strength of the vertebrae can be calculated at different points in time.
These strengths can then be compared to spinal loads and enable an assessment of fracture risk undertaken.
Those vertebrae at high risk would then receive special implant to support the weakened bone and prevent fracture.
This implant would only require key-hole surgery and would not impinge on the patient’s quality of life through a lengthy recuperation period or additional pain.
The OncoEng Research Vision
A research collaboration between the University of Birmingham, Imperial College London and UCL has received funding to develop an alternative approach based on developing new imaging and modelling techniques that will enable clinicians to predict which patients are at a high-risk of a vertebra fracturing.
The project – Oncological Engineering: A new concept in the treatment of bone metastases – has attracted £7 million in research funding, including £5.6 million grant from the Engineering and Physical Sciences Research Council (EPSRC), part of UK Research and Innovation, the Government-funded body set up to support research and innovation.
Within five years, the research team hope to have developed new techniques and materials that will revolutionise the treatment of bone metastases.
The NHS Long Term Plan and the EU’s Beating Cancer Plan for cancer treatment had called on researchers to develop new interventions that would improve the quality of life of patients living with advanced cancers.
It is hoped the new techniques will be applied to other areas of the healthcare sector.
“The problem facing doctors is they have no way of knowing which of the spinal vertebrae is going to collapse. But when that happens, patients may require major surgery which involves a lengthy period of rehabilitation.
Our approach is to intervene by developing new techniques and equipment that will prevent spinal fractures, crucially helping to maintain a patient’s quality of life at a time when they may be terminally ill. ”
Expert in medical engineering at the University of Birmingham who is leading the new OncoEng research collaboration