Alpine Spine & Orthopedics - Cancer Complications and Treatments

Cancer

Providing complex care for detection, prevention, & treatment of cancer complications.

Cancer treatment is much more than just chemo or radiation therapy-- your care should involve a multifaceted approach to give you the best outcome possible and enhance your health, well-being, and ability to fight the cancer throughout the treatment process. We offer many options to optimize treatment outcomes, especially to prevent and treat many of the complex complications that can arise from cancer. For example, we treat anemia, nutritional deficiencies, and fluid/electrolyte imbalances in the clinic with a variety of medications, vitamins, electrolytes, iron, and/or other agents to optimize bone marrow functions before, during, and after your chemo/radiation treatments to increase RBC and WBC counts and enhance outcomes and recovery. We provide certain specialized infusions like zoledronate (zoledronic acid) that can protect bones against cancer metastasis and pathologic fractures (which are known to lead to many further downstream complications with high morbidity and mortality). We also treat the common conditions of pain, nausea, electrolyte imbalances, nutritional deficiencies, and other complications or side effects of chemo/radiation treatments. We can also image many types of tumor masses in the office with ultrasound imaging to monitor their morphology and growth over time. It is important to note that many cancer patients do not directly die of the cancerous tumor itself but from the many complications that can occur along the difficult road of highly consequential treatments.

There is a surprising overlap between stem cell research and cancer research, and Dr. McMurtrey was one of the first researchers to use genetically-modified pluripotent stem cells isolated from patients to model tumor growth and cancer characteristics, in addition to his clinical experience with many adult and pediatric cancers. Cancer is quite clever and adaptive at evading attack through several mechanisms, but there are many new innovative approaches currently being studied in cancer research, including monoclonal antibody immunotherapies that target PD-1 and CTLA-4, cytokine therapy, CRISPR editing for T-cell receptor replacement, T-cell stimulation and adoptive T-cell transfer (1) (2) (3). For an interesting background on how cancer immunotherapy was discovered despite few believing it would work, please read this stunning biographical essay by Tasuku Honjo who won the Nobel Prize in 2018 for his work on the PD-1 and CTLA-4 receptor targets (particularly in dMMR mutations), which ultimately led to a better understanding of thymus functions, autoimmune diseases, how the immune system can attack cancer, and the development of anti-cancer monoclonal antibody medications like Nivolumab, Dostarlimab, Ipilimumab, Pembrolizumab, and others.

Some adjunct treatments that we offer include:

Laboratory blood tests for cancer screening, including the 'Grail Galleri Multi-Cancer Early Detection Test' to detect over 50 types of cancers with high accuracy.
IV infusions of medications, antioxidants, vitamins, minerals, parenteral nutrition, hydration fluids, amino acids, electrolytes, & cancer-fighting adjuncts.
Difficult intravenous vascular access.
Treatments for anemia, neutropenia, thrombocytopenia, and other aspects of low blood counts.
Treatments for fatigue and cognitive functions.
Injections of B12, folate, leucovorin, glutathione, high-dose vitamin C (ascorbic acid), magnesium, glutathione, methylene blue, antioxidants, peptides, and/or other agents.
Bone marrow stimulation and optimization.
Bone marrow prophylaxis and immune function protection prior to chemo or radiation treatments.
Bisphosphanate infusions (zoledronate, aledronate, risedronate, pamidronate, etc.) that protect against metastatic spread of cancer through bones and pathologic fractures (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16).
Infusions and prescriptions for neuropathies, demyelination, and neurodegeneration from chemo/radiation.
Minimally-invasive interventions on tumor mass impingements on nerves or other critical structures.
Treatments for nausea, fatigue, nutritional deficiencies, tumor lysis syndrome, electrolyte imbalances, and other complications or side effects of chemo/radiation treatments.
Pain management, specialized compounded prescription creams, & medical cannabis.
Ultrasound imaging and analysis of tumor masses and morphological growth characteristics.
Investigational and adjuvant cancer therapies such as electrochemotherapy where electrical voltage pulses are applied across the tumor tissue after chemotherapy infusions to enhance permeability of cytotoxic anti-cancer agents across cancer cell membranes in a process called electroporation (studied in various cancers of colon, breast, skin, etc.) (17) (18) (19) (20) (21) (22) (23) (24) (25) (26) (27) (28) (29) (30) (31) (32).
Investigational and adjuvant cancer therapies such as focused ultrasound tumor ablation, which is thought to stimulate immune recognition of damage-associated molecular patterns (DAMPs) and thereby promote immunogenic cell death of cancer cells through adaptive immune responses, thus driving death of cancer cells via abscopal ferroptotic, necroptosic, and/or pyroptosic mechanisms (33) (34) (35) (36).
Specialized lab tests for a broad range of cancer markers, hormones, antioxidants, vitamins, electrolytes, organ functions, metabolic function, bone marrow function, inflammatory markers, and markers of neural injury and neurodegeneration in order to optimize quality of life.

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*Disclaimer: The information presented here is for informational use and cites the ongoing cutting-edge research and medical advancements on these relevant topics. There are many treatments, interventions, and protocols routinely practiced in medicine and surgery which the FDA has not studied nor formally approved yet which have demonstrated overwhelming evidence of efficacy and clinical benefit. The FDA does not regulate the practice of medicine but rather regulates medical marketing of devices and drugs. The FDA does not conduct clinical trials or attempt to discover new treatments, but rather requires companies or other entities to fund marketing approvals. Breakthrough technologies typically require years to decades of research work to optimize the technology and collect enough data to prove efficacy and superiority, which in some cases can optionally be submitted to the FDA if there is sufficient financial backing to market a specific product or drug. Thus the FDA has not yet studied, evaluated, or formally approved many regenerative therapies currently practiced by many of the top physicians and surgeons in the United States and around the world. Some therapies, products, or interventions may still be considered investigational or "off-label" even with substantial evidence of efficacy, and many different applications of regenerative therapies continue to be researched by our institute and other top institutions around the world. We seek to always provide the highest-quality evidence-based care to our patients, which may include FDA-approved therapies as well as additional investigational or alternative therapies. We always discuss potential risks and benefits of all these options. The rapid evolution and advancement of medicine demands that physicians continually update their knowledge and practice techniques to adapt to future improvements and advancing technologies. These statements have not been evaluated by the FDA, and the treatments and products presented here are for informational purposes and not intended or guaranteed to diagnose, treat, cure, or prevent any specific disease or condition. All injuries and conditions should be formally evaluated by a knowledgeable medical professional whereby standard treatments and/or additional therapeutic interventions may be considered with the diagnosis and treatment plan.