John Pizzi was an active, athletic young boy excelling in both soccer and baseball when, at age 11, his mother says he started experiencing severe, persistent pain in one of his legs. Thinking perhaps he had shin splints or a stress fracture, John’s parents tried various home remedies including icing and ibuprofen, but nothing provided permanent relief.
John eventually needed round-the-clock pain medication to reduce his pain from a “six or seven out of 10” to a more manageable level that enabled him to function and continue participating in sports. “For nearly a year he was on almost constant ibuprofen,” says his mother, Margaret. “We kept hoping the pain would go away without serious intervention but it never did, and eventually it just became unbearable for him and he’d had enough. He was even missing up to two hours of sleep a night due to his leg pain.”
Finally, this past summer when John was 12, scans showed that John had a rare, benign tumor in his leg called an osteoid osteoma (OO). Commonly found in long bones, such as the femur and tibia, osteoid osteomas can cause excruciating pain. While the cause of these tumors is unknown, they can affect 10 to 40 individuals per 100,000, comprising 12% of benign bone tumors and 3% of all bone tumors. They are three times more common in males than in females, and the majority are found in children, like John, and young adults.
Upon learning of John’s diagnosis, his parents immediately started conducting their own research to find treatment options for their son, and soon learned of Dr. Matthew Bucknor at the University of California San Francisco’s (UCSF) Department of Radiology and Biomedical Imaging. Dr. Bucknor, who specializes in MR-guided high intensity focused ultrasound (HIFU or FUS) and minimally invasive interventions for musculoskeletal maladies, told the Pizzis about a clinical trial for osteoid osteoma patients like John comparing two OO treatments, focused ultrasound and radiofrequency ablation (RFA). “We were so excited to learn of the clinical trial, and then we were also really, really hopeful that John would be assigned to the focused ultrasound/HIFU group [versus RFA], as his recovery would likely be much quicker – a few weeks versus several months – and he wouldn’t have to miss the entire fall sports season,” said Margaret. “When we found out later that John was going to get the HIFU treatment, we were just ecstatic.”
In August the Pizzis, who reside in Marin County, California, traveled to UCSF for John’s focused ultrasound procedure with Dr. Bucknor. The treatment took just a few hours, and they were able to ablate John’s tumor without any complications. “Because it is completely non-invasive, focused ultrasound offers multiple benefits: The procedure can be performed quickly, the risk of side effects can be reduced, and the recovery period can be significantly shortened,” said Dr. Bucknor. “We’re very pleased with John’s treatment and his subsequent return to an active, pain-free lifestyle.”
“It really couldn’t have gone better,” adds Margaret. “And when John woke up after the procedure was over, the very first thing he said was, ‘Mom! Did the Seahawks win? And what about the Yankees, did they beat the Red Sox?’ We all had a good laugh.”
Remarkably, John only needed a prescription painkiller once or twice in the first few days following his treatment; within three to four days, “he was literally on no pain medication at all – for the first time in more than a year,” said Margaret. “It was amazing. Honestly, the worst part of the recovery period for him was that he had to sit out for three to four weeks from all sports and his P.E. class. It was killing him to sit on the bench, because he really did feel great, but he wasn’t cleared to play again yet. All he wanted to do was run and play.”
Two months post focused ultrasound treatment, John’s mother reports that he still has not needed any pain medicine, and he has even added a sport to his busy, active schedule. He now plays both local fall baseball and travel baseball, soccer, and is running cross-country track for his school. Says Margaret, “The tumor is gone, he has zero pain, zero restrictions … Our boy is back!”
This comparative study builds on previous clinical trials at Children’s National Health System in Washington, DC, and The Hospital for Sick Children (SickKids) in Toronto. We followed two patients who participated in the Toronto trial, which was supported by the Foundation. Watch Jack and Della as they explain what this treatment meant to them.
Click here for a list of FUS/HIFU treatment centers worldwide.