Dr. David Greenberg Brings Orthopaedic Oncology Back to Saint Louis University Hospital 
 
Orthopaedic Oncology is a specialty so rare that generally one specialist can serve a population of a million people. The St. Louis metropolitan area has around 2.6 million people, and had only one full-time orthopaedic oncologist until Dr. David Greenberg joined SLU Orthopaedics in August 2010.

Dr. Greenberg is a board eligible orthopaedic surgeon, who received his medical degree at Georgetown University School of Medicine in Washington D.C. He graduated Magna Cum Laude in June 2003. He did his fellowship in Musculoskeletal Oncology at the University of Chicago. He is an Assistant Professor of Orthopaedic Surgery at Saint Louis University School of Medicine and sees patients at both SLU Hospital and Cardinal Glennon Children’s Hospital.

Dr. Greenberg’s specialty is rare because the cancer and diseases that need an orthopaedic oncologist are rare. An orthopaedic oncologist diagnoses and treats sarcomas, which are malignant cancers of the bone and soft tissue. Only 1% of cancers in adults and 15% of cancers in children are sarcomas.

“We know a lot about a little,” says Dr. Greenberg. “The rare few who are diagnosed with a sarcoma need to see an orthopaedic oncologist.” SLU Hospital uses a multi-disciplinary team approach to cancer treatment. The team consists of medical oncologists, radiation oncologists, surgical oncologists and pathologists. The team will evaluate a patient’s particular cancer and determine whether it should be treated with chemotherapy, radiation, surgery or a combination. Dr. Greenberg is a surgeon on the team. His specialty is removing tumors and restoring the patient’s functionality. He can remove cancer from a bone and reconstruct the bone so the patient still has use of the limb. In some cases, a cancer that originated in another part of the body will spread to the bones, and Dr. Greenberg treats that part of the cancer.

Dr. Greenberg chose oncology as his specialty because of his family. “I have a significant amount of family history with cancer. Once I decided to go into orthopaedics, I felt that orthopaedic oncology was the one area of orthopaedics where I could have the most impact on someone’s life.” Most bone cancers occur in children up to age 20, while soft tissue cancers usually occur in adults over 40. Unlike the more common cancers such as breast, lung or prostate, there is not a lot of research funding available, not enough education about them, nor is any screening routinely done.

“Most people who have bone cancer find it by accident,” says Dr. Greenberg. “It’s typically a teenager who injures him or herself in some way. They have an x-ray and the radiologist notices an abnormality.”

The most common bone cancer is osteosarcoma, which typically occurs in the long bones of the arms and legs, or pelvis. It usually affects active, growing bones, so it occurs mostly in children and teens. If bone cancer isn’t found by accident, it can take some time for it to become painful enough for the patient to see a doctor and get an x-ray. If it goes on long enough, the bone may weaken so much that it fractures during normal activity.

Cancers of the soft tissue are usually found by the patient. “A person will notice a lump on their arm or leg and become worried enough to go to the doctor,” explained Dr. Greenberg. “Fortunately, the vast majority of lumps end up being benign and nothing to worry about.” Dr. Greenberg finds his niche specialty highly satisfying because it’s rewarding at both ends of the spectrum. “When a patient has a very serious disease, such as a cancer in the thigh bone, I’m often able to remove it and reconstruct the bone so they are still able to have both their life and function back. There is a satisfaction to that that’s hard to explain until you experience it,” said Dr. Greenberg.

“Then there’s the flip side. A mother came in with her 15-year-old son the other day because he had a lump behind his ankle. I removed the lesion and we determined it was benign. To see the joy on that mother’s face and hear the relief in her voice when I told her that her son did not have cancer – there’s really nothing else in medicine for me that tops that.”

Having only two full-time orthopaedic oncologists in the entire bi-state area (the other one is at Washington University) can mean getting in to see one can be a challenge. But Dr. Greenberg has made it a policy to see a new patient within a week, two weeks at the most.

“When a person thinks they have cancer, even if it turns out to be benign, the last thing they want is to wait for weeks to be seen,” says Dr. Greenberg. “No matter how busy we become, we intend to maintain that focus.”

SLU Hospital is proud to have Dr. Greenberg on staff, able to serve an underserved area of medicine in the bi-state area. Patients are normally referred to Dr. Greenberg through their primary care physician or oncologist.