Medical Mile produces breakthroughs, innovations

South Bend’s Medical Mile institutions are known and valued for the world-class care that they provide to patients in the region. But they also are recognized for medical research and cutting-edge innovations.

Here are just a few snapshots of medical discoveries and innovations that are occurring right here in South Bend.

Balloon kyphoplasty
Memorial Hospital of South Bend

Osteoporosis, a condition involving the weakening of the bones due to tissue loss, can result from genetics, old age or the use of certain medications or even cancer. In certain cases, osteoporosis can result in compression fractures in the spine. In older individuals, these vertebrae fractures are very painful and can eventually become debilitating.

But doctors at Memorial Hospital of South Bend have provided a beacon of hope with a procedure known as balloon kyphoplasty, which helps patients recover relatively quickly from compression fractures.

Balloon kyphoplasty involves the insertion of tiny balloons into incisions that have been made in the patient’s back. Specifically, the balloons are inserted into the fractured bone and are inflated, which in turn helps realign the vertebra and correct the vertebral deformity caused by the fracture.

After the balloons are gently deflated and removed, the space inside the bone is then filled with a special cement to set the bone, forming an internal cast. Most patients return to their usual activity within a matter of days.

Dr. Bryan Boyer, an orthopedic trauma surgeon at Memorial, is one of the few trauma surgeons performing this procedure in northern Indiana and southern Michigan.

“In the past we really didn’t have much to offer these patients except for a pat on the back, a brace or pain management,” Boyer says. “Now, with balloon kyphoplasty, we will actually put a special balloon inside the bone to jack the bone up, restore the height of the bone, as well as create a cavity to accept the cement. The cement stabilizes while the body does the rest of the healing, so that these people can get up and be mobile almost immediately.”

Boyer says the results are sometimes phenomenal.

“It doesn’t work for everybody, but probably 85 to 90 percent of people notice improvement or significant relief,” he says. “I’ve had some people go out and mow their yards the next day after the procedure. Whereas, left untreated, they could lie in bed for weeks or even months.”
 

Comparative genetic analysis of common cancers
Indiana University School of Medicine-South Bend (IUSM-SB)

Rudolph Navari, M.D., Ph.D., assistant dean and director of IUSM-SB and director of the Notre Dame Cancer Institute

A cancer research group at Indiana University School of Medicine-South Bend (IUSM-SB) uses mouse models that spontaneously develop common cancers (such as colon cancer, prostate cancer and breast cancer) to provide tumors for genetic analysis.

Dr. Rudolph Navari, M.D., Ph.D., assistant dean and director of IUSM-SB, explains that once colon cancer develops in the mouse, a sample of the tumor is analyzed for a genetic profile.

“At the same time, in conjunction with community physicians and surgeons in area hospitals, we are getting samples of human tumors, like colon cancer, from patients in the community who are undergoing elective surgeries,” says Navari, who is also clinical director of the newly formed Harper Cancer Institute. “With the patient’s full understanding and permission, we work with the pathologist to get a sample of the tumor and then analyze it to find its genetic profile.”

The medical researchers at IUSM-SB compare the genetic profiles to see if the human and mouse specimens “overlap,” genetically speaking. If there are overlaps, the researchers can clone the animal gene and attempt to remove the cancer genes to see if that will prevent colon cancer from developing. If this proves successful, the researchers could potentially make gene alterations in humans who may be susceptible to colon cancer genetically.

In addition to colon cancer, this research initiative led by Navari also shows promise in treating prostate cancer and breast cancer.

Testing procedure: fluorescence in situ hybridization (FISH)
South Bend Medical Foundation

In the field of diagnosing malignancies, the South Bend Medical Foundation has developed a new testing procedure called fluorescence in situ hybridization (FISH), which enables oncologists to identify specific genetic abnormalities. FISH is a test that “maps” the genetic material in a person’s cells. This test can be used to visualize specific genes or portions of genes, and also to determine the most effective treatment.

Bob King, senior vice president of the South Bend Medical Foundation, says FISH is significant in a number of ways.

For example the Foundation now performs a panel of FISH tests in patients with chronic lymphocytic leukemia to identify specific genetic abnormalities. Differences in prognosis and the need for conservative versus aggressive therapy can be determined by the genetic profile of the neoplasm. By studying each patient and coordinating testing, the pathologists and technologists ensure that proper FISH and other relevant testing is performed in every case.

In other premalignant and malignant disorders, FISH methodologies help identify specific subtypes of the disease and guide chemotherapy and other therapeutic regimens.

Previous to the identification of the genetic basis of malignancies, clinicians often had to resort to standard chemotherapy regimens, which cause severe side effects. As genetic abnormalities have been determined in some cancers, pharmacologic treatments targeting the effect of these genes has evolved. In many cases, these treatments are more effective and cause fewer side effects then the chemotherapy used previously.

The availability of FISH and other genetic tests at the South Bend Medical Foundation allow oncologists and pathologists to provide sophisticated, coordinated care regimens to local cancer patients.

These three examples illustrate the far-reaching and beneficial medical research under way in South Bend, which enhances the lives of people not only in our region, but around the world.