Few cancer surgeries today are as invasive or life changing as those involving the pelvis, the ring-shaped bone that anchors both the spine and hips. Removing key parts of the pelvis can keep patients off their feet for more than a year. Outcomes are so variable that patients often go into the operating room without a clear idea of what their walking ability will be after surgery.
Soon, pelvic cancer patients at the Texas Medical Center may benefit from Rice University research that uses personalized computer models to help patients and their doctors choose the treatment most likely to best maintain their ability to walk after surgery.
The research, by mechanical engineer Benjamin J. Fregly, Ph.D., is being made possible by a CPRIT Established Investigator Award, which enabled him to move from the University of Florida to Rice’s Department of Mechanical Engineering.
At Rice he will work with collaborators at the TMC to explore developing a center dedicated to preserving the walking ability of patients undergoing surgery for osteosarcomas, or bone cancers—which disproportionately affect children and young adults.
Fregly has more than 30 years experience building computer models to predict how well a patient will function after surgery or rehabilitation. Using motion-capture technology similar to that used by the film industry, Fregly and his colleagues build personalized computer models of patients. These models can simulate post-treatment function for a range of treatment options being considered by the physician.
For pelvic cancer patients, options include removal of the cancerous bone with no reconstructive surgery; reconstruction using a combination of cadaver bone and metal implants; or a custom-designed prosthesis. Each potential treatment has benefits and drawbacks. Fregly’s goal is to maximize each patient’s ability to walk after surgery.
“Custom pelvic prostheses have the potential to maximize walking ability and minimize recovery time, but they are not available clinically because of low reliability,” Fregly said. “That’s an engineering problem that Rice is in a good position to tackle.”
Fregly’s research will help not only in the design of an appropriate prosthesis, but also in guiding the surgeon in how best to preserve function while at the same time removing the cancer. Being at Rice will allow Fregly to collaborate closely with surgeon Dr. Valerae Lewis, M.D., who performs more surgeries for pelvic cancer than anyone else in the U.S. Dr. Lewis is the chair of orthopedic oncology at the University of Texas MD Anderson Cancer Center.
“I am extremely grateful to CPRIT for giving me the opportunity to take the innovative personalized treatment design methods I have been developing for other orthopedic conditions and apply them to cancer surgeries, where every patient requires a truly unique treatment plan,” Fregly said.
“Our hope is to improve the postsurgical functional outcome and recovery time for pelvic sarcoma patients in the Texas Medical Center, regardless of which surgical method a patient receives,” Fregly said.
Also collaborating on the project are Rice mechanical engineers Fred Higgs and Ed Akin, who will provide expertise in the design and 3D printing of custom prostheses, and UTHealth orthopedic researcher Scott Tashman, who will conduct human movement testing for each patient.
Fregly earned his bachelor’s degree from Princeton University and his doctorate from Stanford University before moving to the University of Lyon, France, for postdoctoral studies. He also worked at a Silicon Valley software startup for four years before joining the University of Florida in 1999.
Fregly is no stranger to Rice. His wife, Shirley, is a 1988 alumna, and his son, Christopher, is a student.