Reconstructive microsurgery: What patients should know

Sometimes our surgeons must perform life-altering surgeries to remove cancer. And, in many cases, cancer surgeries have the potential to dramatically change a patient’s physical appearance or lifestyle. But through reconstructive microsurgery, our plastic surgeons are often able to help patients return to their normal appearance or lifestyle. Microsurgery allows surgeons to perform procedures that were once impossible, and they’re using these tools to improve surgery every day. In fact, each year, MD Anderson’s 21 plastic surgeons perform more than 1,000 microsurgeries to reconstruct patients from head to toe. Many of these surgeries are breast reconstruction, when surgeons use the patient’s tissue to create new breasts after a mastectomy. But surgeons may also use this technique for reconstructing other parts of the body.   To learn more about microsurgery, we spoke with plastic surgeons Alexander Mericli, M.D., and Carrie Chu, M.D. Here’s what they had to say. What is microsurgery? Microsurgery gets its name because it refers to surgery performed using a microscope. During microsurgery, we use precise microsurgical instruments that allow us to reconnect very small blood vessels, nerves and lymphatic vessels with very tiny stitches – some thinner than a hair and difficult to see with the human eye. We often use microsurgery in conjunction with other surgeries, such as tumor removal and reconstruction, to reconstruct complicated areas that otherwise wouldn’t be possible. Among other things, we use microsurgery to: reconstruct breast cancer patients’ breasts using tissue from their abdomen or other parts of their bodies rebuild jaws using a bone from the leg, shoulder, arm or hip, or reconstruct tongues with skin and fat from the...

Chondrosarcoma survivor helps other patients find their strength

In early 2009, Hilary McQuiston-Fall was enjoying an active lifestyle full of outdoor activities in San Francisco, California. But when the 26-year-old fell while snowboarding, she realized something wasn’t right. Doctors initially treated her for a broken tailbone, but months later, she was still dealing with pain and swelling. After a battery of tests, Hilary was diagnosed with chondrosarcoma in her right hip. Over the next six years, she received radiation therapy and went through several limb-salvage surgeries, but the cancer kept returning and spreading. “They believe it started in my iliac crest and took over my right side. It was growing over my leg, it was involved in my sciatic notch, femoral nerves — just everywhere,” explains Hilary. In 2015, her local doctor recommended she undergo a hemipelvectomy, a procedure that removes part of a patient’s pelvis and can include amputation of the leg. Through her research, she discovered MD Anderson’s Orthopaedic Oncology department has experts that specialize in this complex surgery. Confidence in MD Anderson’s expertise Hilary made contact with Dr. Justin Bird and spoke over the phone for weeks with his physician assistant, Jillian Chamberlain. Hilary vividly remembers when Dr. Bird called her with his final recommendation: an external hemipelvectomy, which would include amputation of her right leg. After a few weeks of careful thought and more research, she was ready to commit to the surgery and trust Dr. Bird’s experience and expertise. “Dr. Bird was very nice and patient with my decision-making. But I said, ‘No, I want to do it. Schedule me as soon as you can,’.” In March 2016, she underwent the 15-hour...

Q&A: Understanding our Cancer Genomics Laboratory Moon Shot platform

MD Anderson’s Moon Shots Program™ is designed to reduce the time it takes to move promising cancer discoveries into the clinic, where they can help patients the most. The program focuses resources around 13 cancer types, called Moon Shots™, with the goal of using the knowledge we gain to advance treatment of all types of cancer. But how do researchers make cancer discoveries? And how do they know which discoveries are the most likely to have a major impact for patients? That’s where the Moon Shots Program’s Cancer Genomics Laboratory platform comes in. We spoke with Maggi Morgan, scientific manager, to learn more about the platform and how it impacts cancer research and treatment. Here’s what she had to say. What is the Cancer Genomics Laboratory? The Cancer Genomics Laboratory platform is a research lab that drives discovery and understanding of how tumors grow, spread and evolve. Our team provides researchers with data that may, in the future, guide personalized cancer treatment strategies and has the potential to make a significant impact on the detection, management and treatment of cancer. What is genomics, and how is it used in cancer research? Your complete set of DNA is called your genome. Almost every cell in your body, including a cancer cell, contains a copy of the 3 billion DNA base pairs, or letters (A, T, G and C), which string together to make up the genome. Genomics is the detailed study of these sequences of DNA that make up the genome. Cancer is caused by small changes in sequences of DNA. These changes are called mutations, which accumulate over time...

Proton therapy by night: A granular cell cancer survivor’s story

When I was diagnosed with granular cell cancer in May 2017, my doctors at MD Anderson recommended surgery, followed by six weeks of proton therapy. It never occurred to me that I could receive treatment at night, so when my first proton therapy session was scheduled for 10:30 p.m., it freaked me out a little bit. Was that a typo? Why was I being seen so late? I called my care team, and they confirmed the time slot was real. It was also the soonest I could get in, so I kept the appointment. And I quickly discovered that there are many benefits to receiving treatment at night. That’s why I was OK with the remainder of my treatments being in the late night hours, too. Calm, quiet … and zero traffic The MD Anderson Proton Therapy Center is a very busy place. Demand is so high that patients are seen there from 4 a.m. until midnight daily. And as you can imagine, the center is busiest during normal business hours. But by 10:30 at night, it is calm and peaceful, and doesn’t feel like an ordinary clinical environment. And while navigating the Texas Medical Center even outside of rush hour is no picnic, by 10:30 p.m., traffic is practically nonexistent. Even the freeways are a breeze. Distracting myself with adventures Another good thing about scheduling your treatments at night is you have the entire day to work, rest or explore Houston, which is what I did. I really came to love Houston’s parks, museums, leafy streets, and varied districts during my six-week stay — even in the sweltering...

Why managing heart health during and after cancer treatment is critical

Every year, the number of cancer survivors grows. That’s why it’s becoming increasingly important for doctors to make sure cancer treatments don’t cause any lingering side effects — particularly when it comes to heart health. Heart problems are the leading cause of death in Americans each year. Cancer is No. 2. So if we’re able to cure someone’s cancer, we certainly don’t want to leave them with any cardiovascular issues. Chemotherapy drug adversely affects heart function Many cancer treatments can impair heart function. One is the chemotherapy drug doxorubicin, which is used frequently to treat breast cancer, as well as some sarcomas and lymphomas. Doxorubicin has been around since the early 1970s and can reduce the heart’s ability to pump blood. Traditionally, this side effect has been described as “irreversible.” But we’re discovering that some of the patients we give heart-protective medication to show improvement, even years after they’ve completed treatment. So, that’s great news. And, only about 2% of breast cancer patients will experience heart-related side effects from receiving the typical dose of doxorubicin. That goes up to about 5% in lymphoma and sarcoma patients, because of the higher doses used to treat those cancers.  Other treatments that affect heart function Another drug that can affect the heart negatively is trastuzumab, which is a type of targeted therapy. Its effects have classically been described as “reversible.” That means if we stop administering the drug, the side effects disappear and the heart typically returns to normal within about four weeks. But even with newer targeted therapies, we are seeing less than 1% of patients have decreased-heart-function-related side effects.   Radiation...