When I arrived at the Ochsner Cancer Institute in New Orleans at the end of 2009, they were doing only one or two peritoneal mesothelioma cases each year — not very many. It’s a rare cancer, and unfortunately, patients didn’t really know where to go.
Now we’re seeing a real influx — several cases this month — because we’ve put a real priority on it. And we’re seeing some good results. We are set up well here to do this kind of thing because we are doing so much liver, pancreas and pelvic work, too. We’re doing operations all the time that are more complex than this.
We’re actually set up perfectly for it. If you only have practice doing peritoneal mesothelioma, you won’t be in the operating room long enough. This has to be tied to a practice where you keep your skills sharp doing all sorts of other complex stuff.
We’re happy with the cytoreductions we’ve done for mesothelioma. They’ve helped the patients. You don’t really know for another five years exactly how much, but the preponderance of evidence shows that it’s helping significantly. You have to have some luck on your side, but the results seem to be so much better now.
Expanding the Success at Ochsner
Our success, in part, is because of the work previously done by veteran doctors at other centers. It allowed me to figure out (pre-op) who I can help, and who I can’t. They’ve been down that road, so I don’t have to go there.
If a patient is healthy enough to get here, we can usually help them. Someone who has unresectable mesothelioma in the belly is going to struggle to get here.
The center just bought a new machine to do the HIPEC (Hyperthermic Intraperitoneal Chemotherapy) because it is working so well. We’re doing more and more of these cases, and probably going to get a second machine here.
Part of this is getting the patients to a specialty center like ours, where experience is so important. It’s not the patients, though, we have to convince; often, it’s the referring physician.
Much of the medical community still has the perception that nothing can be done for mesothelioma, but it’s just not true anymore. We have to change that. The patients are just looking for anything that may help them. A lot of times, the patients are never referred. Often they come to me after they’ve seen somebody else, who has told them there is little they can do.
We can help these patients. My colleague, Dr. Rodney Landreneau, handles pleural mesothelioma cases, and I handle the peritoneal ones.
More and more data is coming out that shows the outcomes are considerably better at a center like ours when dealing with these complex problems. We have a built-in system that works. We’re not just guessing what to do. It’s not some amazing conclusion that you’re going to be better at something you do more often. That’s true with anything.
Mesothelioma cytoreduction is a complex operation. You better be committed to it. You have to be ready for a 12-hour case. We are. These other operations we do, like a complex pancreas or liver case, can be just as long. And it’s not just the surgeon and the intraoperative part. We’ve got great post-op care, as well.
From the patient-care perspective, we’re pretty good there all around. We have things available now to make it as easy as possible for the patients and families to get through it. It’s easy to navigate our system.
I think we’re more patient friendly than some of the other centers in other places. Maybe it’s because of our size. Our nurses act as navigators. We have people involved who can coordinate a lot of things for you, like home care and follow-up care with local physicians.
This is just a good place to be.