Research into tumor paint, glue embolization treatments and other fields of oncology care has allowed practitioners in the Bone Tumor and Sarcoma Clinic to provide unparalleled cancer care to children in the Pacific Northwest.

The Bone Tumor and Sarcoma Clinic is one of the first of its kind in the U.S. in which orthopedic surgeons and oncologists work side by side in the same program. The clinic’s expertise includes two surgeons with fellowship training in both pediatric orthopedics and musculoskeletal surgical oncology and a third with training in both pediatric and adult musculoskeletal oncology. Their interdisciplinary backgrounds and emphasis on collaborative care has resulted in one of the largest, most comprehensive bone and soft tissue programs in the country.

An emphasis on communication

At weekly bone tumor conferences, oncology, orthopedic and radiology teams review and discuss individual patient cases. An additional weekly clinic that includes a broader group of providers offers another opportunity for clinicians to maximize each child’s progress.

“Sarcoma requires team-based care,” says Dr. Suzanne Yandow, chief of Pediatric Orthopedics and Sports Medicine at Seattle Children’s and professor of orthopedic surgery at UW Medicine. “We have to have constant discussions about patients in group settings, and we have an entire team of oncologists, nurse practitioners with expertise in sarcoma care, social workers, and others who attend these weekly meetings.”

Improving care through research

“Our oncologists are not only members of the Children’s Oncology Group (COG), but also leaders of clinical studies in COG,” says Dr. Douglas S. Hawkins, division chief of Hematology-Oncology at Seattle Children’s and professor of pediatrics at UW Medicine. “Through COG, we provide the most up-to-date clinical trials to children, adolescents and young adults with cancer. In addition, we offer a wide range of investigational agents from a variety of new agents consortia, including the COG Phase I Consortium.”

Internally, practitioners in the Bone Tumor and Sarcoma Clinic work closely with an on-site group of expert pediatric pathologists with extensive experience in diagnosing pediatric sarcomas, as well as other departments engaged in advanced treatments and research.

One such treatment arose out of a collaboration between the Vascular Anomalies, Interventional Radiology and Orthopedics departments. A team from Seattle Children’s originally pioneered a safer method to remove venous malformations in the head and neck by first injecting them with n-butyl cyanoacrylate (n-BCA) glue. The technique has been expanded to now treat children with malformations in extremities.

Since physicians started using it more than four years ago, glue embolization has now become standard of care for venous malformations at Seattle Children’s.

“Once they’re in that form, they’re more easily resected, which leads to less blood loss and loss of function,” Yandow says. “This is groundbreaking work.”

A recent trial in Seattle Children’s Neurosurgery Department on BLZ-100 Tumor Paint, which marks tumors in the brain, is being adapted for use in the Bone Tumor and Sarcoma Clinic. BLZ-100, invented by a team led by Dr. Jim Olson, pediatric neuro-oncologist at Seattle Children’s, is administered by intravenous injection prior to surgery. In the operating room, the tumor glows green when viewed under a laser light and imaged with a near-infrared camera system, allowing surgeons to excise tumors without disrupting normal tissue. In the future, Dr. Olson hopes tumor paint may allow surgeons to excise tumors without disrupting normal tissue.

“We have pediatric expertise in every domain,” Yandow says. “It’s those partnerships within the hospital that make our oncology care as good as it is.”

Call 206-987-7777 for provider-to-provider patient consults and visit the Bone Tumors and Soft Tissue Tumors page to learn more.