Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. J. Dominic Femino, Chief of the USC Musculoskeletal Oncology Center

Transcript

Dr. J. Dominic Femino, Chief of the USC Musculoskeletal Oncology Center · Becker’s Healthcare - Clinical Leadership Podcast

• 0:00
  Welcome everyone to the Becker's Healthcare podcast series.
• 0:02
  I'm Mariah Muhammad, writer and moderator with Becker's
• 0:05
  Healthcare. And I'm thrilled to have with me
• 0:07
  today doctor Joseph Dominic Femeno
• 0:10
  from Keck Medicine of USC.
• 0:13
  Doctor, welcome to the podcast. We're very excited
• 0:15
  to have you join us today. To get
• 0:16
  a start, would you mind please introducing yourself
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  and tell telling us a bit about your
• 0:20
  background?
• 0:22
  Sure. Thank you very much, Mariah. It's nice
• 0:24
  to be with you.
• 0:26
  My name is Dominic Fomino. I am Chief
• 0:29
  of
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  the USC Musculoskeletal
• 0:32
  Oncology Center
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  and an orthopedic oncology surgeon at Keck Medicine
• 0:37
  of USC.
• 0:39
  I have been practicing
• 0:41
  orthopedic oncology surgery for 25 years
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  in various
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  specialty sarcoma centers
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  in Southern California.
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  I have
• 0:54
  fellowship training experience in both,
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  orthopedic oncology
• 1:00
  as well as pediatric orthopedics,
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  which,
• 1:04
  meshes very well together as many of our
• 1:07
  patients
• 1:08
  with bone and soft tissue tumors are pediatric
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  age,
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  as well as adults.
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  And
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  the
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  experience here at USC
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  is one that I'm very excited about
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  to to grow a new sarcoma program
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  that
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  was preexisting,
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  but to, to fortify it and expand it.
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  So I'm very excited to be at Keck
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  Medicine of USC.
• 1:39
  Yeah. Absolutely. Thank you so much for giving
• 1:40
  us that background. So,
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  what are your top priorities,
• 1:45
  ending this year and going right into 2025?
• 1:49
  Yeah. So the top priorities for
• 1:52
  our sarcoma program at USC
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  are,
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  really to expand
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  our offers of clinical trials.
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  And these are new,
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  targeted drug therapies that can be done in
• 2:07
  can be administered
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  to patients with sarcomas in the research setting.
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  And also to expand
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  and continue to expand our
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  technologies that we use in surgery.
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  As an orthopedic oncology surgeon, we
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  have
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  lots of new emerging technologies that are very
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  important
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  for the treatment
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  of our patients for sarcoma.
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  And these help
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  improve the
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  quality of life of our patients as well
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  as reduce their complications,
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  hasten their recovery,
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  and provide,
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  you know, the
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  cutting edge,
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  quality of care, for these patients.
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  So those are really the top priorities,
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  for the coming year.
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  Wonderful. Thank you for sharing. Are are there
• 2:59
  any programs or initiatives,
• 3:01
  that have been the most needle moving for
• 3:03
  you, in this year 2024?
• 3:07
  Yes. There's,
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  there's been some significant changes in
• 3:12
  treatment
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  for our orthopedic
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  tumor patients
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  and
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  some things that
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  have really changed
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  the way we treat their bone tumors,
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  particularly around the pelvis. So the first initiative
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  would be
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  a minimally invasive type of surgical intervention
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  for bone tumors around the pelvis.
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  Whereas before,
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  patients who had cancerous bone tumors around the
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  pelvis,
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  oftentimes
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  required large surgeries
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  to
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  resect their tumor and reconstruct
• 3:52
  their pelvis around the hip joint.
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  It would involve a prolonged surgery,
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  a very prolonged recovery time,
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  delays in their chemotherapy
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  so that they could recover for surgery.
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  And now we have
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  technologies
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  that we've developed in the last
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  few years that
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  have changed this to minimally invasive,
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  percutaneous
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  techniques,
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  where through very small incisions,
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  we can
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  perform
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  ablation of the bone tumor
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  with a radio frequency probe
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  and then provide
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  stabilization
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  of the pelvic
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  bone lesion,
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  with injection
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  of cements or acrylic
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  bone fillers as well as
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  internal fixation
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  with hardware that can be done percutaneously.
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  It's been a big change for the treatment
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  of these patients and that
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  it significantly relieves their pain while allowing them
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  to recover
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  extremely quickly.
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  Most of these procedures are done with either
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  a one day hospital stay or outpatient
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  and the patients are able to get up
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  and walk immediately.
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  And they're having
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  excellent results with resolution
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  of their pain and
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  treatment of their tumors.
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  So that's a technology that I think is
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  really important
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  for our patients,
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  that's been developed recently.
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  Other things that we're looking forward to
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  for the future would be other surgical technologies
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  that
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  involve
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  the reduction of infections
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  around
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  large implants.
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  In sarcoma surgery, when we take out
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  a sarcoma, which is a cancerous tumor of
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  the bone or soft tissues that starts in
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  those locations,
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  we take out a large segment of bone
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  with a joint,
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  usually and we have to reconstruct that.
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  And there are some new techniques that we're
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  using
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  to
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  use implants that help
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  their metal implants that replace bones and joints
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  that,
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  have,
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  some bactericidal
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  components to them to help reduce the infection
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  rate.
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  In addition to that,
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  one of my partners, Doctor. Zuckerman,
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  has
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  been a pioneer
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  in using a biologic solution to replacing bone
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  defects after we take out
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  a bone tumor
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  and transporting the patient's remaining native bone
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  and advancing that very slowly
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  into the bone defect,
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  in a non invasive way using
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  a growing
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  rod that has a motor within it that
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  can transport a piece of bone to regenerate
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  new bone
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  in a defect.
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  And so these are things that I think
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  are really exciting
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  for our future,
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  as well
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  as things that we've been working on here
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  that
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  can really change the way we treat patients
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  and
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  provide solutions for them for their sarcomas.
• 7:11
  Yeah. Absolutely. That that sounds very promising.
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  Is there any type of what you're thinking
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  about growth and patient experience,
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  going into 2025?
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  Yeah.
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  Growth is important.
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  It has to be done
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  to maintain the program,
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  but it's important not to lose sight of
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  the patient experience,
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  when you're growing.
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  Quality
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  of patient care needs to be maintained
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  and
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  patients want ease of access.
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  The thing about sarcomas is it's different than
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  many other cancers. There's only about
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  13,000
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  soft tissue sarcomas a year and about 8,000
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  bone sarcomas a year in the United States.
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  This is a very small percentage compared to
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  other more common cancers like breast or prostate
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  where there may be
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  270,000
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  a year.
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  So there's a very small patient population and
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  because of that,
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  it's really important for patients to be treated
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  at a sarcoma center where you have
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  a multidisciplinary
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  team
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  that has expertise in the treatment of sarcomas.
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  And
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  those types of centers are usually at major
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  academic centers
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  in major cities.
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  And
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  there is a significant difference in how a
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  patient
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  gets treated at a sarcoma center with an
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  expert sarcoma team compared to
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  a community hospital where somebody
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  may be treating only 1 or 2 sarcomas
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  a year or even every couple of years.
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  So in order
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  to get the best possible treatment with the
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  best possible outcomes,
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  it's important for patients to go to these
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  large sarcoma centers,
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  where we have the expertise.
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  Now, patients don't want to be traveling
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  100 of miles to get to a sarcoma
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  center. So,
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  unless you live in a major metropolitan city
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  like Los Angeles where I live,
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  patients don't have many options. So it's
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  so one of the things
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  that we can offer
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  patients is
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  our expansion
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  out into the community. So instead
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  of coming to downtown Los Angeles
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  to our Keck Medical Center,
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  We can offer much of our specialized sarcoma
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  team
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  care,
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  at other community offices that we have around
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  the Greater Southern California area where we have
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  the expertise
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  to physicians,
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  who have the expertise to
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  meet with patients in those centers, so they
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  can get localized care from the expert sarcoma
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  physicians.
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  And so that's one of the things that
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  we've done and we're continuing to do
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  to really offer that expert care out in
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  the community.
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  It's also important
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  to recruit and have the experienced team
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  in maintaining that patient experience.
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  If patients
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  get inadequate care or inappropriate care,
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  it really is detrimental
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  to the type of treatment
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  and their outcomes
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  and it may result in them coming to
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  us later
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  where they have to get
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  more extensive surgery,
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  may have to add
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  different types of
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  reconstructive
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  procedures
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  and things like that that may be detrimental
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  to their function and ultimately to their outcome.
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  So
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  we're really trying to
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  offer the best possible care upfront to those
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  patients
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  by making ourselves accessible
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  in those community sites where patients,
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  can get access to specialty sarcoma,
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  physicians,
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  in a more local setting.
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  Yeah. Thank you so much for sharing that
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  very important information. Those final thoughts, doctor. This
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  has definitely been, an informative discussion. So I
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  wanna again, I wanna thank you so much
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  for coming on Becker's HealthCare.
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  And I look forward to connecting with you
• 11:21
  again soon.
• 11:23
  Thank you very much. I appreciate it. Thank
• 11:25
  you.