The Connective Tissue Oncology Program (CTOP) studies two populations of patients with cancer of the connective tissues: the skeleton and its supporting soft tissues. It is composed of 26 members from 11 department with more than $3.3 million in annual direct support. The cancers studied are either primary or metastatic to these groups of tissues. Sarcomas, or primary cancers of connective tissues, are uncommon forms of malignancy, particularly in comparison to the epithelial cancers, yet represent a raison d'etre of cancer centers: multi-disciplinary oncology. All current practice guidelines underscore the need to have multi- disciplinary teams of physicians and other professionals to care for patients with these uncommon malignancies. Success has been clearly achieved with the approach of combining the medical or pediatric oncologist with the surgeon to produce markedly improved cure rates for bone cancer (osteosarcoma, Ewing's sarcoma), and to a lesser extent, of soft tissue sarcomas. While cancers of the connective tissue are much more common in soft tissue than in bone, the reverse is true when one considers metastatic cancers where metastasis to the skeleton is far more common that metastasis to the soft tissue supporting that skeleton. Metastasis to the skeleton is a very common phenomenon associated with human cancer. The prevalence and predilection of metastasis to the bones, despite its commonality, is one of the more poorly understood processes associated with cancer. Even more devastating are the symptoms caused by the metastasis and the relative ineffectiveness of current treatments. The research areas related to sarcomas and metastatic bone tumors represent a common research foci. For example, the bone microenvironment primarily consists of mesenchymal cells similar to the cells from which sarcomas originates from. Additionally, the biology of sarcomas and metastatic cancers is similar in terms of growth characteristics (e.g. slow growth). Accordingly, we think combining these two areas of concern into a single program makes good sense, and in particular, unifies the strengths at this Cancer Center.
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