Beth:
Have you heard of any promising clinical trials with chondrocarcoma? I am starting a BMS-CDK study in May at the Farber with the goal being to stop/shrink tumor growth. Question #2: How does one find "the best" surgeon. At some point in the future, I may need surgery for this chondrosarcoma on my right pelvis. I have met a surgeon in Boston, think he is qualified, comes highly recommended etc. But how do I know? Can you recommend the top three? Location is not an issue.

Dr. Lackman:
There is no standard chemotherapy for chondrosarcoma. We have however published very exciting data on the use of Cipro and Taxol on chondrosarcomas. We have shown and published data that Cipro (an antibiotic) kills human chondrosarcoma in culture and we have had some very good responces treating these tumors with the Cipro and Taxol. If you are interested in this you should call my associate at the Joan Karnell Cancer Center, Dr. Chip Staddon. He can be reached at 800-789-PENN. In terms of surgeons, we do a great deal of this sort of surgery here at Penn where we have one of the busiest centers in the country. There is certainly no need to leave Philadelphia for a pelvic chondrosarcoma resection. If you prefer to go to Boston then I would recommend Dr. Fran Hornicek at Harvard.

Paulguy:
Dr Keenan, I have had orthoscopic surgeries to remove torn cartildge in both knees. I have had a series of Synvisc in both knees... I am currently getting my second series of Synvisc injections. My question is: How many times can Synvisc be administered?? Is there a limit since it is dissapated through the body naturally in approx 6 mos and relief lasts approx (for me) 12-18 mos.... Would switching to Hyalgen make a difference??? Would appreciate your opinion... Thanks.

Dr. Keenan:
This question would best be answered by one of our total joint surgeons. [See below]

Dr. Craig Israelite:
There have been no reported adverse effects with multiple rounds of viscosupplementation (providing no allergic component). Therefore I would say that as long as the patient receives at least 6 months or more of relief, I see no harm. Several of my patients have received multiple courses of Synvisc. Although I do not have any data, I doubt that switching would provide any additional relief. Total joint replacement is indicated after failure of non-surgical treatment only.

K. Hartwyk:
What, if any, treatments are there for condomelatia?

Dr. Keenan:
I suspect that you mean chondromalacia. Chondromalacia is a softening of the cartilage on the surface of a joint. It can happen in any joint but the kneecap is particularly vulnerable. The best doctor to see for this problem is an orthopaedic doctor who specializes in sports injuries.

Donna:
T2 dependent layering of hypointense material, with hyperintensity anteriorly. Poss.hemorrage or proteinaceous fluid cyst. At level of lower 3, there is a linea rstructure traversing the spinal canal in the APdimension dividing the canal in two parts. At mid L1 the spinal cord divide into 2 halves above the septum. L3-4 mildlynarrowed.Disc dehydration at all visualized levels. L5-S1 Disc bulge. What type of operation will be necessary. My main complaint is severe pains from my knees to feet, after I have been lying down about 1hr. at night only, I must get up a walk it off. Not always both legs. No pains while up or walking. I'm now taking neurontine 300mg/3day.

Dr. Keenan:
It looks like you've sent us part of the report from an imaging study of your spine. These problems are best evaluated by either an orthopaedic surgeon or a neurosurgeon who specializes in spine disorders.

Terrie:
Hi Dr. Lackman! You saved my daughter Andrea's life 3 years ago after she was dxed w/ Ewing's Sarcoma! Today is her 26th birthday, and I thank you with all of my heart that you kept my daughter alive to see this day! We love you! She is now an RN at St. Chris' in the NICU.

What is new in the pelvis limb saving surgeries, for sarcomas such as Ewings? Again, I thank you with all my heart!

Dr. Lackman:
Hi Terrri. There is really nothing new since Andrea was treated. We still try to combine all possible treatments to fit each protocol to each patient. I would do nothing different today in regard to Andrea and I would hope for the same great result. She is quite a young woman and I am sure you are very proud of her! Thanks for the kind note.

Terrie:
Thank you. And anyone who is reluctant to see any of the Docs at Penn Orthopeadics, I can tell you that these Drs., Lackman, Sennett, etc. are fantastic. Do yourself the favor and make the appointment. You will be glad you did.

Tom:
Hello. I had the limb salvage surgery at the Univ of Penn back in 95. I had a osteogenic sarcoma in my right leg. I thought it was a great show tonight. I have never met anyone who had the same surgery I had undergone. Is there a way I can help someone directly who went through the same experiences that I had gone through?

Dr. Lackman:
Thanks for offering. It is often helpful for our patients to speak with others who have been through the same treatment. If you send me your age and the type of surgery you had done, I will be happy to keep you in mind for this. Also, are you keeping up on your follow up visits? You shold still be getting an x-ray of the surgical site and a CT scan of the lungs yearly out to ten years.

Andrea:
My 5 year old son had a bone biopsy to rule out Ewings sarcoma almost 10 months ago. After the final pathology report came back,he was found to have chronic osteomyelitis. Could that chronic inflammation make him more prone to a sarcoma in the future. He is extremely tall for his age

Dr. Lackman:
Fortunately not. Infections have no relationship with sarcomas so he is at no more risk than anyone in the general population

Barbara:
I have an app. w/ Dr. Lackman in July. I have been diagnosed w/myositis ossificans, a calcification pressing in my muscle, I'm taking anti-inflam. drugs, but is still painful. What can be done about this and does it ever go away. thank you

Dr. Lackman:
Now that Dr. Mary Ann Keenan has joined Penn Orthopaedics, you should probably see her instead. She is a specialist in this problem and treats many such cases. It may well require a surgery to fix and Dr. Keenan could give you good advice regarding that.

Lynne:
Hi, i had a chondrosarsoma 12 years ago in my pelvis and hip bone and Dr. Lackman did the surgery..I had to have a hemipelvectomy. i went to a cancer center in NY for a 2nd opinion and they told me to get my affairs in order...I am still here 12 years later thanks to Dr. Lackman.....I LOVE HIM!!!

Dr. Lackman:
I LOVE you too!!!!!! Thanks for the kind note and for being such a good patient and friend.

Barbara Jean:
What are the signs and symptoms of bone cancer?? Does surgery for stomach cancer make you more susceptible??

Dr. Lackman:
The signs and symptoms of bone cancer are usually pain which gets progressively worse and may be associated with a lump. Stomach cancers almost never show up in the bones but any symptoms such as I mentioned should still cause you to be evaluated

John:
Hi Drs Keenan and Lackman,
How's everything going. I was a patient of both of you and I just wanted to say the program was great and that I am doing very well.

Dr. Lackman:
John, Thanks for the kind note. We are doing well and I am pleased that you are also. Have fun

Sharon:
What does it mean when a bone scan shows increased density?

Dr. Lackman:
A bone scan is very sensitive but not very specific. An abnormality can be compatible with a large variety of things such as arthritis, injury, infection, tumor, inflammation and so on. Depending on the quality and location of the bone scan abnormality, further studies such s x-rays, MRI Scan or CT scan may be indicated.