Orthopedic Surgery Bring Relief From Painful Cancer Complications

As Cathy Lang found out, early stage breast cancer is no walk in the park – in fact, eventually it would take away her ability to walk.

While she was in her fifties, the Baltimore resident was diagnosed with breast cancer and successfully treated at her local community hospital. However, five years later her treatments led to leukemia – cancer of the bone marrow. In rare cases like Cathy's, leukemia is caused by chemotherapy and radiation therapy for another cancer.

Known for its bone marrow transplant (BMT), the University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center (UMGCCC) is where she received a bone marrow transplant and chemotherapy that cured her leukemia.

However, one specific part of her treatment – prednisone – caused Cathy's bones to deteriorate. Prednisone is a common steroid medication, and most people who take it do not develop bone problems. However, treatment for blood cancers can require large doses of prednisone. In those cases, steroid-induced osteoporosis – weakening and loss of bone – is often a side effect.

"I was in so much pain with my bones. It wouldn't go away, and I couldn't find relief from medications," says Cathy. Eventually, she was limited to using a wheelchair to get around.

Very pleased with the care she had received at UMGCCC, Cathy once again turned to the University of Maryland Medical Center for help with her bone pain. "The hospital's the best; you can't ask for a better place to receive treatment," she says.

"Cathy had disabling pain that we managed conservatively as long as possible," says Dr. Vincent Y. Ng, Assistant Professor of Orthopaedics at the University of Maryland School of Medicine and a specialist in orthopaedic oncology. The orthopaedic surgeons at UMMC strive to first provide treatments that do not involve surgery. Many patients are helped by these non-surgical approaches and do not need operations. However, Cathy's bone loss was so severe that the blood vessels in some of her bone joints were dying off, and surgery became necessary.

"I was so weak that my husband had to hold me up for X-rays," she says.

Cathy's first orthopaedic surgery involved one of her feet. The tarsal bones where her foot met the ankle had become so brittle that Cathy experienced excruciating pain whenever she put weight on her left foot. She was treated by Dr. Jacob Wynes, Assistant Professor of Orthopaedics at the University of Maryland School of Medicine and a podiatrist at UMMC, who specializes in foot and ankle surgery.

"I now have a metal rod and nuts, bolts, and screws, but Dr. Wynes saved my foot," Cathy says with gratitude.

The bone loss also affected both of Cathy's hips. To regain her ability to walk, she needed bilateral total hip replacements, or two operations six months apart. Each surgery replaced one of her hip joints.

"Given her past cancer diagnoses and treatments, Cathy was a relatively high-risk candidate for surgery," says Dr. Ng. "But we could see that replacing her hips was the only way she was going to achieve the pain relief she was looking for and be able to walk again."

Dr. Ng says that Cathy did "excellent" with her surgeries; there were no complications and her pain is now mostly gone. Cathy is likewise pleased with her results. The day after her second hip surgery, she was out of bed and walking the halls. "It was amazing," she says. She also points out there was hardly any scaring from her hip operations.

Today, Cathy volunteers with patients at the UM Greenebaum Comprehensive Cancer Center to ease their concerns. Despite all of the side effects she experienced from her treatments – "Whatever you couldn't get, I got it" – Cathy remained a fighter. She has now been cancer free since May 2018 and, thanks to UMMC's orthopaedic and podiatric surgeons, wheelchair free since October 2018. As such, she is an inspiration to patients with cancer and can empathize with them as they go through ups and downs.

"You can just feel the love at the University of Maryland Medical Center," Cathy says, who is happy she can now play a role in the extra support the hospital gives its patients. "I let patients know they are in the right place. I tell them, 'If you want to live, go to the University of Maryland because they fight for their patients.'"