A major £7 million research collaboration between UCL, the University of Leeds and Imperial College London has been launched to develop a new imaging and keyhole surgery approach to treating secondary bone tumours of the spine.
Known as metastatic bone disease, the condition is particularly associated with breast cancer, and occurs when tumours from a primary cancer spread to bone. This can cause vertebrae to weaken and eventually fracture, leaving patients in severe pain, immobility and requiring surgery. In some cases the fracture can damage the spinal cord and cause paralysis. For these patients, quality of life is a key issue and complex surgery may be inappropriate.
Researchers from UCL, the University of Leeds and Imperial College London will 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.
Patients would then be fitted, using minimally invasive surgery, with a tailor-made implant to strengthen the spine and prevent fracture. The implant would be made from a metamaterial, a material that has uncommon properties that can be fine-tuned to the needs of the patient, for example it can harden under stress.
UCL lead Professor Rebecca Shipley (UCL Mechanical Engineering) said: "This funding will enable us to significantly expand our work combining computational modelling with cutting-edge imaging to better understand how cancers grow and interact with surrounding tissues. We are excited to use these multidisciplinary frameworks to understand vertebra fracture risk and ultimately help to improve quality of life for cancer patients."
Patient imaging and computer modelling will enable researchers to track tumour development in the spine over time and how it might be weakening individual vertebrae. This information would be compared with the loading on the spine, enabling clinicians to predict which of the vertebrae are at risk of fracturing.
Around 150 people are diagnosed with breast cancer every day in the UK, and although more than 76% will survive for more than ten years, some patients develop stage 4 cancers (where the disease has spread to other organs), of which it is estimated about 50% to 60% get bone tumours.
Project lead Professor Richard Hall (University of Leeds) said: "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 often 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."
The advanced manufacturing group from the Dyson School of Design Engineering at Imperial College London will be developing a new 3D printer capable of fabricating the intricate implant designs. Their machine will use smart optical systems to print photopolymers at extremely fine resolution.
Co-investigator Dr Rob Hewson (Imperial College London) said: "This project allows us to expand our expertise in the analysis, optimisation and 3D printing of structural metamaterials. By working as part of the multidisciplinary team we aim to apply the new approaches and knowledge to improve the quality of life of late-stage cancer sufferers. We will also be able to apply some of these new approaches back into the aerospace and mechanical engineering sectors where advanced meta-materials have a wide range of potential applications."
The team hope to have developed new techniques and materials that will revolutionise the treatment of bone metastases within five years. Using minimally invasive techniques to implant the material, the recovery period for patients will be days, rather than weeks or months for surgery following a spinal fracture.
The project is part-funded by the Engineering and Physical Sciences Research Council (EPSRC), part of UK Research and Innovation (UKRI).
Dr Kedar Pandya, Director for Cross-Council Programmes at the EPSRC, said: "Through improvements in imaging and modelling and a personalised approach, this project has the potential to revolutionise the treatment of secondary bone tumours. It demonstrates the importance of fundamental research and engineering solutions in developing new treatments that will have a profound impact on people's lives."
