Physician Spotlight on Dr. Zachary Cavanaugh

How did you get interested in orthopedic oncology and complex reconstruction?

I was initially drawn to orthopedics in medical school after witnessing its impact on restoring patient function as well as the tangible before and after results with surgical intervention. During residency, I came to understand the true spectrum of restoring function and quality of life. In orthopedic oncology I found that patients came in with sudden and unexpected functional limitations all while facing challenges from their underlying diagnosis and treatment. I was drawn to these patients and the potential to have such a profound impact on their lives by restoring their ability to perform basic day-to-day activities.

What is your practice philosophy?

My practice philosophy is based on the understanding that every patient is unique and there is no such thing as a ‘one-size fits all’ approach. Every patient has different goals and expectations for their quality of life. I feel it is my job to help patients achieve these goals.

At times, it is also important to collaborate with family members and other medical specialists on a patient’s treatment team. This holistic approach ensures that we focus on treating not only the symptoms or diagnosis, but the entire patient.

What are your clinical interests?

As an orthopedic oncologist, I treat a wide range of both benign (non-aggressive) and malignant (aggressive) bone and soft tissue tumors encompassing the upper and lower extremities. In addition, my fellowship training and skill set lends itself to treating patients with simple and complex fractures all over the body, as well as those with difficulty from previous total joint replacements. I have a special interest in complex reconstruction and limb salvage surgery for patients with unexpected issues after prior orthopedic surgery, including infection, severe bone loss, or disability despite multiple revision procedures.

Why should patients see an orthopedic oncologist for soft tissue ‘lumps & bumps’ or abnormalities in the bone?

I think it is important to reassure patients that the majority of soft tissue masses and bone tumors are not aggressive or cancerous. However, they are often identified when a patient develops pain or discomfort at an extremity or joint. An orthopedic oncologist is able to assess the nature of the mass or tumor, as well as provide appropriate treatment for the musculoskeletal complaint.

When patients do have findings suggestive of an aggressive mass or tumor, we are able to develop the best course of action to determine the diagnosis and next steps in management. If surgery is indicated, we have the expertise to optimize function and mobility while providing appropriate care of the cancer. In addition, orthopedic oncologists work as part of a multidisciplinary team with local oncologists, including those at the Middlesex Health Cancer Center. Middlesex Health is the first organization in Connecticut to become part of the Mayo Clinic Care Network. This partnership provides an incredible opportunity for the team at Middlesex Health to collaborate with specialists at the Mayo Clinic, incorporating world-class expertise while still receiving care close to home.

What trends are you seeing in orthopedic oncology? What are you currently excited about?

The field of orthopedic oncology continues to be impacted by the advances and improvements in systemic treatments for many patients with metastatic bone disease. Patients are living longer, and when surgery is indicated, we are utilizing more durable reconstruction techniques. When the location of the tumor puts a joint at risk, a megaprosthesis can be used to reconstruct the joint, minimizing the need for any future surgeries.

On the other end of the spectrum, I’m excited by the advances in minimally invasive techniques, particularly around the pelvis. These techniques allow us to provide pain relief and restore ambulation for patients who would not have been candidates for surgery in the past.  

What’s your favorite part of your job?

My favorite part of my job is connecting with patients and seeing the before and after result after both operative and non-operative intervention. Often times patients come in with severe pain, limited function and poor mobility. Watching the benefit on their quality of life as they regain function motivates me to go to work every day. I am amazed by my patients’ resilience and positivity despite the challenges they face on a day-to-day basis.  I often develop long term relationships with patients and their families as we continue to work together to optimize their quality of life.

What are your personal interests?

Outside of work, I enjoy spending my free time with my wife and two young children. I like to run and ski, and when the weather is warm, I enjoy swimming, boating and going to the beach with the family. 

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