Keeping People Moving

Thousands of people are walking — and running — today because surgeons have replaced their damaged joints. In fact, many advances in joint replacement surgery were pioneered by orthopedic surgeons at Rush. But researchers at Rush also look for ways to alleviate joint problems without surgery.

According to Joel Block, MD, a rheumatologist at Rush, changing the way people walk may help.

Block and others are studying biomechanical loading of the knee — the force exerted on this joint as you walk.

Previous evidence suggested such loading can be reduced by altering the way the foot is positioned, and Block's group designed a shoe insert that does just that. The insert — which mimics barefoot walking — reduces the load on the knee by about 12 percent.

"For people in this study, their pain got substantially better and the progression of their condition was significantly reduced," Block says.

If this ongoing study confirms the benefits of relieving the biomechanical load on the knee, it could mean therapies such as shoe inserts could help some people delay joint replacement surgery.

Joel Block, MD, researches osteoarthritis and cartilage cell biology and has published numerous articles on these and other issues in rheumatology.

Hitting a Moving Target

Radiation therapy has helped thousands of people become cancer free. But it can cause side effects such as red, blistered skin; fatigue; nausea and vomiting.

Newer cancer treatments aim to lessen these problems by killing the cancer without harming normal cells. Rush is on the leading edge of these targeted treatments with technologies that do just that.

For example, a special computed tomography (CT) scanner uses 4-D to focus radiation at targets that don't stand still.

"With lung cancer, the tumor can move as the patient breathes," says Thomas Zusag, MD, a radiation oncologist at Rush. "We use the movement pattern to target the treatment."

Standard CT scanning works by taking multiple x-rays as it rotates around the patient. The 4-D CT has an additional sensor that reconstructs the movement of the tumor through the respiratory cycle. This creates a composite picture of the area the tumor occupies over time. Sophisticated treatment machines, such as Varian Trilogy and TomoTherapy, then use this information to direct radiation to the exact area, sparing surrounding tissue. Both of these treatment options are also available at Rush.

Precise treatments such as these spare normal tissue and reduce side effects, which is also the goal of targeted drug treatments — to kill the cancer without harming normal cells.

There are many kinds of targeted drug therapies, and researchers at Rush are working to find more. According to Stephanie Gregory, MD, hematologist and oncologist at Rush, Rush is participating in the development of a drug called an SYK inhibitor that works by preventing cancer cells from dividing, while sparing healthy cells. If approved, it will be an important tool for fighting cancer. Targeted therapies are often used in combination with other cancer treatments. Find out about other cancer therapies by visiting www.rush.edu/discover.

Stephanie Gregory, MD, specializes in blood cancers. She is involved in research on targeted therapies for cancer and is the medical director of the Section of Hematology at Rush.

Thomas Zusag, MD, researches precision radiation treatments and specializes in lung and gynecologic cancers.
To make an appointment with a physician at Rush University Medical Center, call (888) 352 RUSH (7874).

Did You Know?

Medicine isn't confined to hospitals. Rush reaches out to the community with a variety of health care programs for disadvantaged children and adults. Rush also sponsors after-school science clubs and helps build modern science labs in public elementary schools to encourage future researchers. It's all part of moving medicine forward.