Sad news today from Roger Ebert- his cancer has returned.

Ebert, the Pulitzer Prize winning Chicago Sun-Times film critic known for his movie review shows Sneak Previews, At the Movies with Gene Siskel and Roger Ebert, and Siskel and Ebert and The Movies, was first diagnosed with thyroid cancer in 2002. Ebert originally underwent radiation therapy, and partial removal of his salivary glands to treat the disease.

Unfortunately the cancer recurred in 2006, and he had to have part of his jaw removed. As he was getting ready to leave the hospital, his carotid artery (the main artery that supplies blood to the brain) burst, and with the hospital staff’s quick actions, and emergency surgery which removed most of his lower jaw and placed a tracheostomy tube in his windpipe, Ebert’s life was saved. He has undergone several difficult reconstructive surgeries since that time, but is still unable to speak, and has to be fed through a tube.

Despite all this, his outlook on life has remained positive, and along with the support of his wife Chaz, and his friends and colleagues, he has continued to write his Sun-Times column as well as setting up the online review site, rogerebert.com.

In December, Ebert was hospitalized after sustaining a hip fracture, which he joked was caused by “tricky disco dance moves.”

Today, on his online journal, Ebert revealed that:

The “painful fracture” that made it difficult for me to walk has recently been revealed to be a cancer.

He is currently receiving radiation therapy, but still intends to write, although at a more deliberate pace- thus his so-called “leave of presence.”

We wish Roger Ebert the best for a speedy recovery.

A fracture which occurs in a bone which has been weakened by another disease process, is called a pathologic fracture. The most common cause of pathologic fractures is weakening of the bone due to osteoporosis. Other abnormalities include tumors, infection, and certain structural and inherited bone disorders. Unlike fractures of normal bone, pathologic fractures can occur during normal activity or minor trauma.

Tumors associated with pathologic fractures can either be primary or secondary (or metastatic) bone tumors. Primary tumors include by benign and malignant tumors that arise from the bones themselves. The most common benign bone tumor is called osteochondroma, and occurs most often in people between the ages of 10 and 20.

Cancerous (malignant) bone tumors include:

• Chondrosarcoma
• Ewing’s sarcoma
• Fibrosarcoma
• Osteosarcomas

Cancers that start in another part of the body (such as the breast, lungs, or colon) are called secondary or metastatic bone tumors. They behave very differently from primary bone tumors- typically more like the kind of cancer from which they arise.

The most common cancers that spread (metastasize) to the bone are breast, lung, kidney, prostate, and thyroid carcinomas. This accounts for approximately 700,000 new cases of cancer each year.

Treatment of pathologic fractures can be tricky since you have to (1) stabilize the fracture and (2) treat the surrounding tumor.

Tumor invasion of a bone can make it more difficult to stabilize, and external fixation (pins or plates) may be necessary. In addition, the usual healing process in these patients can be changed by the treatments they are undergoing for their cancer such as radiation and chemotherapy. Nonunion ( the inability of the broken ends of a fractured bones to grow back together) is more common in pathologic fractures.

UPDATE 4/4/2013

Roger Ebert passed away today, less than 2 days after announcing the recurrence of his cancer. In his last blog, he optimistically wrote that his sickness actually would fulfill a long-held fantasy: “Reviewing only the movies I want to review.”

R.I.P. Roger.