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destruction. This model has proven to be a key approach for deciphering cellular responses. Satcher’s team has identified a molecule, BIGH3, secreted by invading cells, that appears to be central to producing the coordinated activity leading to bone destruction. They are now working to establish proof of principle in showing that osteolytic bone lesions can be treated by blocking interactions coordinated by BIGH3. This work will be used for clinical trials testing new drug combinations for reducing tumor progression in bone. Satcher is also the principle investigator for the bone metastasis tissue bank. The purpose of this repository is to store samples of bone metastasis tissue from patients undergoing orthopaedic procedures. This tissue is an invaluable tool, providing patient samples for the entire institution and research community that is focused on studying bone metastasis. With these samples, a precision approach for targeting bone metastasis treatments is envisioned for individual patients. Finally, Satcher is conducting a study to evaluate the use of telemonitoring for patient follow up and recovery after palliative orthopaedic surgery. “I initially was involved with using telemedicine as an astronaut, where I served as the medical officer for our crew Division of Surgery | Surgical Outcomes FY18 33 Hemiarthroplasty 14.46% Hemipelvectomy 7.45% Femur resection 20.77% Humerus resection 7.54% Sacrectomy/spine 10.43% Soft tissue sarcoma 14.90% Total arthroplasty 24.45% Volumes 14.46% 20.77% 7.45% 7.54% 10.43% 14.90% 24.45% Orthopaedic oncology major cases percentage in FY16/17/18 Hemipelvectomy FY16-18 85 Soft tissue sarcoma FY16-18 170 Orthopaedic Oncology Major Cases in FY16/FY17/FY18 on orbit. Our current work at MD Anderson is helping us to understand how to use virtual care, videomonitoring, and telemonitoring techniques, to most efficiently care for cancer patients,” Satcher says. “It can be difficult for patients to return to the medical center following surgical procedures because of both distance and expense. If we can manage these patients just as well using technology (i.e. live video, remote electronic monitoring), it provides benefits to the patient (reduced costs, convenience), and is helpful in making our clinics more efficient. We are in the final phase of the study, and so far have found that both patients and doctors report that using mobile surveillance is acceptable, and enables postoperative care that is subjectively comparable to a face-to-face visit. This pilot study will be used to design additional studies using mobile surveillance for comprehensive patient care.” 34 MD Anderson Cancer Center PLASTIC SURGERY Charles Butler, M.D. Department chair Thomas Campbell Division of Surgery | Surgical Outcomes FY18 35 When there are missing structures and tissue following treatment, our plastic surgeons step in to restore form and function and improve aesthetics for patients. The department’s surgeons have pioneered techniques that are the gold standard for care and perform complex surgeries not done elsewhere. “We have the chance to improve a patient’s quality of life, and our colleagues rely on us to do so,” says Charles Butler, M.D., chair of Plastic Surgery. “Knowing we can reconstruct essentially any defect allows them to be more aggressive with tumor resections to save a patient’s life.” Butler and his team of 23 plastic surgeons perform a host of procedures. These include: • Tissue flaps • Skin grafts • Free-tissue transfer • Reconstruction of all body areas (breast, torso, extremities, pelvis, head and neck, and trunk) • Soft tissue transplantation In addition to common reconstructions, the team executes innovative procedures such as: • Robotic and minimally invasive plastic surgery • Lymphedema surgery • Complex abdominal wall reconstruction • Complex head and neck reconstruction • Reconstructions are not limited to cancer type. Plastic surgeons manage the results of care from all diseases and also treat wounds, infections, tissue loss and injuries from cancer therapies. In FY18 the Plastic Surgery team saw 3,447 new patients and performed 2,115 primary plastic surgery operations. Plastic surgeons see patients at MD Anderson in the Texas Medical Center, West Houston and Sugar Land. Staying in the race by Kellie Bramlet Blackburn Mary Lindimore has completed sprint triathlons, half marathons and most recently the IRONMAN Waco 70.3 triathlon. She has also overcome three different types of breast cancer and debilitating lymphedema, a common cancer treatment side effect that causes blockages in the lymphatic system and leads to swelling and pain. “I couldn’t have done it without the lymph node tissue transfer surgery,” Mary says. “It’s a real gift, and MD Anderson gave that to me.” Mary developed lymphedema in 2007, during her first round of treatment for HER-2+ breast cancer. Her arm was so swollen she had to buy specially made clothing. Nothing made it better, not even treatments like wraps and massages. Then, in 2016, when Mary was diagnosed with breast cancer for the second time, she decided to seek a second opinion at MD Anderson. There, not only did she receive breast cancer treatment, but she also saw Mark Schaverien, M.D., a plastic surgeon who specializes in treating lymphedema. He explained that Mary’s lymphatic system was like a clogged
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