Grant: Project Grant

Many malignant cancers can spread (i.e. metastasize) from their site of origin. A very common site of this spread is to the bone. The spine is the most common bone tissue affected. Diseased bones can cause pain and are at a greater risk for breaking (i.e. fracture). Metastatic disease in the bony spine can present as bone destroying (osteolytic), bone forming (osteoblastic) or as a mixture of the two (mixed), but all demonstrate an increased risk of fracture. In the presence of cancer, we have shown that differences exist in the quality of the remaining bone (in both its mineral and organic components) leading to compromised material and mechanical behaviour. This characterization has formed a robust foundation upon which we propose to evaluate the impact of systemic and localized cancer treatments on bone quality in the metastatic spine. This research will elucidate the complex interactions of multimodal cancer treatment on bone quality and fracture risk in the spine using state-of-the-art medical imaging, experimental and computational methods. Our work will link preclinical and clinical data sets to enable translation of this knowledge towards informing clinical practice. The ability to accurately determine the impact of treatments on structural integrity will provide an important foundation upon which to direct new and existing local and systemic treatments for spinal metastatic disease.