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Early, Late-Stage, and Metastatic Cancers of the Bone
Precision Treatment Options for Primary and Metastasized Bone
Cancers
Cancers affecting the bone are either rare, late-stage, or both, highlighting the need for specialized precision
oncology treatment options to impact the cancerous bone cells. At Envita Medical Centers, a center of excellence for
precision oncology, we have been treating late-stage and complicated cancers for over 25 years with innovative new
treatments. Our team of integrative physicians go beyond standard surgery, radiation therapy, hormone therapy, and
chemotherapy, to effectively target the cancer cells in the bone, and help patients progress towards long-term
remissions.
Envita’s proprietary new treatments, such as CIPI™ (Chemo Immuno Precision Injections), immuno-ablation, and GTFC™
(Genetically Targeted Fractionated Chemotherapy), are designed to provide the benefits of targeted therapies to all
our
patients in this area of orthopedic oncology. We utilize a combination of the latest in conventional medicines and
research-based natural agents to potentiate outcomes, even when patients were left with limited treatment options in
other standard healthcare specialty hospitals.
One of the most important aspects about bone cancer is the delivery method to get treatment to the actual
bone. Our
extensive experience of working with mostly complicated and advanced cancers for over two decades has led us
to the
strategy of utilizing precision minimally invasive surgeries to get to the bone and try to shut down the
tumor right at
its site, while simultaneously reactivating the immune system to get the patient to respond to care.
This article deals with the varied aspects of bone cancer and its treatments, including:
Difference Between Bone Cancer and Bone Metastasis
All cancers affecting the bone need not necessarily be bone cancers, which technically defines cancers originating in
the bones. These cancers starting in the bones are also called bone sarcomas, which are rare, statistically comprising
less than 1%
of all cancers.
Most cancers of the bone affecting adults, generally start in other parts of the body, such as, breast, prostate,
lung,
or kidney, and spread to the bone as metastatic cancers. These cases of secondary bone cancers are also known as bone
metastases, which indicate progression of cancer, and the urgent need for specialized late-stage metastatic
cancer treatment.
Medical studies indicate that bone
metastases are
a common complication of cancer, with breast and prostate cancers being the most
common types to metastasize to bone [1]. When cancerous cells from other parts of the body, such as breast cancer
cells,
impact the bone, they are treated as metastatic breast cancer, and not bone cancer.
Primary Bone Cancer or Bone Sarcomas
Starts in the cells of the bone or cartilage in any part of the body
Generally, primary bone cancer spreads to the lungs, but may spread to lymph nodes, liver, or other organs,
as well
Not as common as bone metastasis, in adults
Can be categorized under stages 1, 2, 3, and 4, signifying early or late and metastatic stages
Secondary Bone Cancer or Bone Metastasis
Starts in the cells of any other part of the body, but spreads to the bone
Cancer from other parts of the body, such as breast, prostate, colon, or lung, spreads to the bone
More common than bone sarcomas, in adults
Bone metastasis generally points to late-stage cancers, as it indicates that the cancerous cells have
proliferated
beyond their site of origin
According to the American Cancer Society, the spine
is the most common site for bone metastases. Other common sites are the hip bone (pelvis),
upper leg bone (femur), upper arm bone (humerus), ribs, and the skull.
When cancer cells spread to the bone, they block or speed up the action of the bone cells, osteoblasts and
osteoclasts,
leading to osteoporosis, bone fractures, or formation of excess new bones. This metastatic spread to the bone can also
lead to other complications like increased level of calcium in the blood, which translates to a poor prognosis for
patients.
Medical reviews indicate how bone metastases
can lead to skeletal-related events (SREs), such as pathological fractures, hypercalcemia,
and spinal-cord compression, and are associated with shortened survival, decreased quality of life, and increased
medical care cost [2]. Current treatments of bone metastases are palliative and aimed at managing SREs and improving
patient quality of life, but this review shows that nanomedicines could provide better treatment options, which is
what
our expert team is already working with here at Envita Medical Centers.
Envita Medical Centers Medical Team
Physicians with MD, MD(h), and NMD medical
licenses, including certified oncologists, and certified interventional radiologists,
striving to provide the latest cancer innovations
22
Pharmacists specializing in integrative agents
7
Nurses trained in precision treatment delivery
40+
Personalization to Overcome Challenges of Standard Treatments and Clinical Trials
At Envita, we take cancer care to the next level with our personalized precision oncology approach, which can be a
gamechanger in the treatment of both bone cancers, such as osteosarcomas, and bone metastases. In our clinical
opinion,
patients with these rare or advanced cancers, need specialized care, going beyond the NCCN
(National Comprehensive Cancer Network) guidelines. These standard guidelines determine care based on cancer type and
stage, without considering each patient’s individual cancer-causing factors.
Type of Tumor and Incidence of Bone Metastasis
at 5 years
Type of Tumor
Incidence of Bone Metastasis at 5 years
Prostate Cancer
Type of Tumor
24.5%
Incidence of Bone Metastasis at 5
years
Breast Cancer
Type of Tumor
6.0%
Incidence of Bone Metastasis at 5
years
Lung Cancer
Type of Tumor
12.4%
Incidence of Bone Metastasis at 5
years
Renal Cancer
Type of Tumor
8.4%
Incidence of Bone Metastasis at 5
years
Colorectal Cancer
Type of Tumor
2.1%
Incidence of Bone Metastasis at 5
years
Gastrointestinal Cancer
Type of Tumor
3.2%
Incidence of Bone Metastasis at 5
years
Source: Hernandez
RK, Wade SW,
Reich A,
Pirolli M, Liede A, Lyman GH.
Incidence of
bone
metastases in
patients with
solid tumors: analysis of oncology electronic medical records in the United States. BMC Cancer. 2018;18(1):44.
Published
2018 Jan 6. doi:10.1186/s12885-017-3922-0
Personalizing care to attack the unique set of genetic factors responsible for the cause and spread
of cancer in each
patient, leads to better responses, potentially reducing the chances of bone metastasis. However, standard healthcare
specialty hospitals cannot personalize care, but Envita being a truly integrative clinic can personalize care by
breaking away from the NCCN guidelines, which does not allow access to precision oncology as first-line treatments.
At Envita, Every Patient Gets Access to Personalized Precision Oncology
From the Beginning of Care!
The handful of patients who get access to precision oncology in standard healthcare specialty hospitals, receive a
watered-down version of Envita's detailed Personalized Precision Oncology Program. We examine many more parameters,
including inflammation markers, analytes, and several other genetic and epigenetic factors influencing changes at the
cellular and molecular level.
Envita Precision Algorithm vs. Standard Oncology Precision Testing
Envita Medical Centers
Standard Oncology Precision Testing
RNA Transcriptome Genes
Envita Medical Centers:20,000+
Standard Oncology:Unchecked
SNV/CNV Genes
Envita Medical Centers:452
Standard Oncology:309
Rearrangements/Fusion Genes
Envita Medical Centers:51
Standard Oncology:27
Microsatellite Instability (MSI)
Envita Medical Centers:Checked
Standard Oncology:Checked
Tumor Mutation Burden (TMB)
Envita Medical Centers:Checked
Standard Oncology:Checked
BRCA 1/2
Envita Medical Centers:Checked
Standard Oncology:Checked
Immunohistochemistry
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Chemosensitivity
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Concurrent Liquid Biopsy
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Exosomal miRNA Analysis
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Circulating Tumor Cells Enumeration
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Pharmacogenomics
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Individualized Therapy Recommendation
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Carcinogenic Exposure - Root Causes
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Inflammation Markers
Envita Medical Centers:Checked
Standard Oncology:Unchecked
Metabolic Target Drivers
Envita Medical Centers:Checked
Standard Oncology:Unchecked
*Individual results may vary. Envita
makes no guarantees for outcomes.
This detailed analysis enables us to better target the individual cancer-causing factors of each patient, potentially
leading to even better responses than clinical trials. Though some patients may assume clinical trials offer them the
latest and greatest treatment options, they must approach these large sample clinical trials with
caution, as these trials focus on testing the efficacy of new drugs or treatments, and do not personalize care
to attack each patient’s unique set of cancer drivers.
Envita’s Unique New Treatments for Bone Cancers and Bone Metastases
Our team of integrative physicians utilize the N-of-1 clinical trial approach to strike at all the
possible causes responsible for each patient’s bone cancer or bone metastasis[3]. This
single subject clinical trial considers an individual patient as the sole unit of observation in a study investigating
the efficacy or side-effect profiles of different interventions, steering towards an optimum patient outcome.
At Envita, we follow a 4-step approach to personalize a unique medical blueprint for each individual patient, which
is
designed to optimize quality of life, increase longevity, and reduce toxicities.
Step 1
Genomic Identification for Better Understanding of Bone Tumors
The key to Envita’s world-class revolutionary care is tumor-specific precision genomic analysis of real-time
mutational
rates and immune targets. Accurately targeting the expressions of bone cancer and other cancers with bone metastasis
is
crucial to improve outcomes and doing so may even avoid chances of bone metastasis in early stages of other cancers,
such as breast, prostate, or lung cancer.
Late-stage cancers with bone metastasis pose significant challenges to standard-of-care treatment regimens because
their
failure could be one of the reasons why the cancer metastasized to the bones originally. Standard oncology’s
one-size-fits-all, blanket treatments have little flexibility within their protocols to deal with the rapidly changing
mutations of cancer, especially in the late stages. To overcome this challenge and better understand the cancer’s
trajectory, we utilize NGS (Next-Generation Sequencing) based proprietary genetic testing, which leads us to accurate
real-time data about the cancer’s latest mutations.
Precision analysis of this up-to-date genomic data helps in identifying actionable targets for care, including
important
factors, such as, the cancer’s microenvironment. The cancer’s microenvironment contains many crucial elements that
need
to be addressed in order to successfully eradicate the tumor and halt metastasis. These elements include several
factors, such as, Vascular Endothelial Growth Factors (VEGF), Microsatellite Instability (MSI), and Circulating Tumor
Cells (CTCs).
Vascular Endothelial Growth Factors, or VEGF,
promotes the
formation of new and irregular blood vessels, which can help tumors grow, leading to further
spread of cancerous cells [4]. Microsatellite
Instabilities (MSI) are theorized to be the outcome of mutations that occur during DNA replication, and they can
facilitate the continued
mutation of cancerous cells in the bone and throughout the body, resulting in constantly changing treatment targets
that
can complicate and derail treatments [5].
Finally, treating the causes of cancer can be just as important as attacking cancerous cells themselves, which
is why
our extensive genomic analysis is also utilized to
identify toxins, infections, and other harmful agents that may limit treatment efficacy, leading to
cancer metastasis. To overcome such treatment challenges, we test and address all these factors in each
patient’s
personalized protocols, enabling them to experience true personalized care with the potential of best outcomes.
Step 2
Immuno Targeting to Help Prevent Cancer Spread
Evidence suggests that Circulating Tumor Cells (CTCs)
carry
the most recently mutated form of the cancer’s genetic markers [6].
CTCs are parts of a growing tumor which break away from it and enter the patient’s bloodstream, spreading the
disease
to
different parts of the body. Envita employs its proprietary Ultra Analytes liquid biopsy to corral these CTC’s
and
provide real-time genetic information, utilized to determine the chemotherapy and immunotherapy agents with the
potential of best outcome in each individual patient.
Standard cancer care does not adequately address the continuously updating genetic information on cancer
biomarkers
and
chemo susceptibility, which are important for staying ahead of the constantly changing cancer environment.
Biomarkers
refer to the proteins, genes, and other molecules which influence your cancer’s growth and proliferation.
Equipped with this biomarker information, our integrative physicians design patient-specific protocols, which
include various levels and types of personalized immunotherapies to
potentially prevent cancer spread. A healthy immune system can precisely and efficiently kill thousands of cancerous
cells daily, which is why our personalized protocols are designed to bolster the body’s immune system in its fight
against cancerous lesions. Recent medical
studies show how immunotherapy may be one of the few hopes for patients with unresectable bone metastases [7].
At Envita Medical Centers, we go beyond standard immune checkpoint inhibitors to include personalized
epigenomic and
miRNA immunotherapy designed to downregulate oncogenes and upregulate tumor suppressor genes. Oncogenes are
responsible
for perpetuating the growth and spread of cancer, while tumor suppressor genes can reactivate the body's immune
response
against cancerous cells. With a host of such personalized immunotherapies in our tool kit, we aim to target the core
causes of each patient’s bone cancer or bone metastasis.
Step 3
Personalized Drug Design for Comprehensive Cancer Care
At Envita, we are not limited by the bone cancer and bone metastases drugs available on the
market, as we go
beyond the
scope of standard bisphosphonates, zoledronic acid, and even radiopharmaceuticals, to impact the deep-seated
cancerous
cells. We custom-compound adjuvants at our in-house pharmacy to target the
biomarkers revealed through our extensive genomic analysis and liquid biopsy. These adjuvants are based on
advanced phytotherapeutics and include plant extracts and herbs, which work more than just basic supplements.
Several medical reviews
indicate how various plant-derived chemical compounds show promise as anti-cancer agents, which is why we
utilize their
benefits to potentially improve patient outcomes [8].
FDA Approved Drugs
Optimized for your cancer mutations.
Repurposed Drugs
Off-label use of approved medications
Custom Compounded Adjuvants
Genetically typed for each patient.
In our clinical opinion, this personalized drug design
including a combination of FDA (Food and Drug Administration) approved drugs, repurposed drugs, and custom compounded
adjuvants, provides targeted options for comprehensive cancer care. We even adjust the dosage of FDA approved and
repurposed drugs to sync with the rate of metabolism of each individual patient, while combining them with the most
effective adjuvants to reduce treatment side effects, such as osteonecrosis.
Step 4
Precision Deployment for Reducing Side Effects and Potentially Improving Outcomes
Precision deployment of our personalized anti-cancer medications is crucial to potentially improve outcomes and
reduce
side effects, especially for aggressive mutations in certain late-stage and advanced cancer patients. In certain
bone
cancers or bone metastases, the tumors can be difficult to penetrate or reach through traditional chemotherapy
or
radiotherapy options, but our proprietary new treatments, including interventional radiology procedures, may
overcome
these hurdles.
We custom design our protocols to not only strike at the cancerous cells in the bone, but to strengthen them
going
beyond surgeries and bone cement injections to improve their functionality. Our minimally invasive procedures
and
intravenous therapies are driven towards helping bone cancer and bone metastases patients, recover holistically.
CIPI™ (Chemo Immuno Precision Injections)
The CIPI™ procedures ingenuity lies in its personalized interventional radiology approach that precisely delivers
genetically targeted medications directly into the cancerous bone tumors, while leaving the patient with potentially
reduced side-effects. This minimally invasive procedure delivers micro-dosed chemotherapy and immunotherapy agents
directly at the site of the tumor, to deactivate it. The antigens released by the tumor are utilized to create a
systemic immune response throughout the body, which is crucial to check chances of a potential recurrence or
metastasis.
Envita's CIPI™ vs. Standard Surgery
Envita Medical Centers
Standard Surgery
Minimally invasive so it can be performed within 40-50 minutes, without the need for large surgical
incisions.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
Can be performed multiple times, even at close intervals, because there is minimal risk of post-op
complications.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
No need for general anesthesia, reducing the health risks that can result from being put into a
medically induced coma to perform an invasive surgery.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
Faster recovery time as compared to traditional surgery, due to the minimally invasive administration.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
Provides direct tumor targeting, which delivers patient-specific genomic agents into the tumor.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
Causes a systemic immune response where the immune system is reactivated to find and attack other
metastatic cancer sites in the body.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
Performed by highly trained medical professionals in an outpatient setting, so there is no need of
hospital stays for recovery.
Envita's CIPI™:Checked
Standard Surgery:Unchecked
*Individual results may vary. Envita
makes no guarantees for outcomes.
Immuno-ablation is another innovative and leading-edge therapy that allows Envita’s team of physicians to
precisely
ablate painful spinal and bone tumors, after establishing immunoreactivities to the cancer. This kind of
treatment is
crucial for cancers of the bone as the bone is a hematopoietic organ that is involved in the origination of
red blood
cells and immune cells.
Our unique ablative techniques focus on reestablishing the body’s immunity to the cancer and then removing
the tumor
using a minimally invasive approach that allows for faster recovery. We use extreme heat or cold to destroy
the
cancerous cells through radiofrequency or cryoablation, which are a part of our immuno-ablation treatments.
Immuno-ablation is an ideal alternative to highly invasive surgeries, which have their own risks beyond the tumor
itself. This ablative technique can destroy painful metastatic tumors in a simple outpatient procedure with minimal
potential for side-effects.
In cases of widespread bone metastases, chemotherapy may be recommended to target the cancerous cells. However,
standard
maximum dose untargeted chemotherapy may do more harm than good in late-stage cancers, as it can lead to more
aggressive
mutations and further cancer spread. To counter such challenges, Envita utilizes GTFC™, which administers low dose
chemotherapy, but increases the mechanisms of action against the cancer. GTFC™ uses metronomic dosage of a greater
number of chemo agents to maximize the potential of response in each individual patient.
Envita's GTFC™ vs. Standard Chemotherapy
Envita Medical Centers
Standard Chemotherapy
Helps to improve chemotherapy delivery to the tumor using a "Trojan Horse" delivery mechanism.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Uses genetic molecular profiling to understand all the facets of each patient's specific cancer.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Uses targeted treatment to enhance the mechanism of cancer kill.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Uses microdosed (fractionated) chemotherapies, reducing the chances of impacting healthy cells.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Minimizes toxicity to normal cells, lowering the chance of side-effects related to administration.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Uses patient-specific supportive immunotherapy to strengthen the immune system.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Aims to reduce multidrug resistance by administering 10 - 20% of the medication delivered in maximum dose
chemo.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
Allows custom-compounded medications to be readministered in tandem to suit each patient's individual cancer
mutations.
Envita's GTFC™:Checked
Standard Chemotherapy:Unchecked
*Individual results may vary. Envita
makes no guarantees for outcomes.
If you have any of the following symptoms, imaging tests, such as x-ray, CT scan, or bone scan may be used to
diagnose
whether you have cancers of the bone:
Bone Pain
Bone fractures
Back pain
Numbness or weakness in the legs
Hypercalcemia induced constipation, nausea, and vomiting
Types of Cancers of the Bone
Bone Metastases: Cancers from any part of the body spread to the bones
Osteosarcoma: The most common type of primary bone cancer, usually develops in the long bone of your legs
Ewing Sarcoma: Commonly affects the hip bones, ribs, shoulder blades, and chest wall
Chondrosarcoma: Generally, affects the cells of the cartilage, which are connective tissues around some
parts of your bone and joints
Chordoma: An uncommon type of bone tumor affecting the bones of the spine or the base of the skull
Multiple Myeloma: A rare type of cancer, starting in the plasma cells found in the bone marrow
Hear from Some of Our Survivors of Different Types of Cancers of the Bone
Disclaimer: Individual results will vary. Envita makes no guarantees for outcomes. Each patient case is unique. Please
consult your doctor before making any changes to your medical treatment. Not every patient is a candidate for care or
achieves these results. Treatments used in this case may not all be FDA approved for the treatment of this condition.
Disclaimer: Individual results will vary. Envita makes no guarantees for outcomes. Each patient case is unique. Please
consult your doctor before making any changes to your medical treatment. Not every patient is a candidate for care or
achieves these results. Treatments used in this case may not all be FDA approved for the treatment of this condition.
Our expert medical team undergoes extensive training of over 1,500 hours to adapt to this personalized precision
oncology approach, which is crucial in treatment of cancers, especially rare and late-stage cancers, such as, bone
cancers and bone metastases. We strive relentlessly towards building a unique treatment plan for each individual
patient, designed to uproot the disease from its core. If you or any of your loved ones have questions regarding
cancers
of the bone or any other cancers, please call us at 866-830-4576. May God bless you on your journey to healing!
References
[1] Bedard G, Chow E. The failures and challenges of bone metastases research in radiation oncology. J Bone
Oncol.
2013;2(2):84-88. Published 2013 Apr 22. doi:10.1016/j.jbo.2013.04.003
[2] Adjei IM, Temples MN, Brown SB, Sharma B. Targeted Nanomedicine to Treat Bone Metastasis. Pharmaceutics.
2018;10(4):205.
Published 2018 Oct 25. doi:10.3390/pharmaceutics10040205
[3] Lillie EO, Patay B, Diamant J, Issell B, Topol EJ, Schork NJ. The n-of-1 clinical trial: the ultimate
strategy
for
individualizing medicine?. Per Med. 2011;8(2):161-173. doi:10.2217/pme.11.7
[4] Kowanetz M, Ferrara N. Vascular endothelial growth factor signaling pathways: therapeutic perspective. Clin
Cancer Res.
2006;12(17):5018-5022. doi:10.1158/1078-0432.CCR-06-1520
[5] Monument MJ, Lessnick SL, Schiffman JD, Randall RT. Microsatellite instability in sarcoma: fact or
fiction?. ISRN Oncol.
2012;2012:473146. doi:10.5402/2012/473146
[6] Van der Toom EE, Verdone JE, Gorin MA, Pienta KJ. Technical challenges in the isolation and analysis of
circulating
tumor cells. Oncotarget. 2016;7(38):62754-62766. doi:10.18632/oncotarget.11191
[7] Liu C, Wang M, Xu C, et al. Immune Checkpoint Inhibitor Therapy for Bone Metastases: Specific
Microenvironment and Current Situation. J Immunol Res. 2021;2021:8970173. Published 2021 Nov 28.
doi:10.1155/2021/8970173
[8] Desai AG, Qazi GN, Ganju RK, et al. Medicinal plants and cancer chemoprevention. Curr Drug Metab.
2008;9(7):581-591.
doi:10.2174/138920008785821657
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