Treatment & Doctors

Advances in Thoracic Oncology Conference Focuses on Mesothelioma Treatment

Written By:
Apr 03, 2014
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Written By: Tim Povtak,
April 3, 2014

The Fox Chase Cancer Center in Philadelphia doesn’t handle as many pleural mesothelioma cases as some of the other specialty centers, but the care it provides them and outcomes it produces are second to none.

Mesothelioma cancer is a high priority.

“I don’t think you can get better care anywhere else,” said Walter Scott, M.D., chief of thoracic surgical oncology at Fox Chase. “We’ve got the experts with experience. And we’ve got that great support team around them.”

Scott spoke at the conclusion of the sixth annual Advances in Thoracic Oncology Conference last week. The program, which included presenters from Fox Chase and other specialty centers, was aimed at medical professionals and focused on the latest advances in mesothelioma treatment. The audience included surgeons, radiation oncologists, pulmonologists, physician assistants and nurses, including Karen Selby, our nurse at The Mesothelioma Center.

Growing Hope for Mesothelioma

Prashant Shah, M.D., thoracic surgeon at Fox Chase, told, “There is real reason for hope now with mesothelioma.”

“We’re not moving mountains, but we are making steady progress,” Shah said. “There still is a long way to go, but we’ve come a long way, too. Attitudes [toward mesothelioma] are changing.”

Shah spoke on “Strategies for Treatment of the Pleura During Surgery for MPM” (malignant pleural mesothelioma). He touched on the staging system and adjuvant therapies used at Fox; the ongoing debate on whether surgical candidates are better served by the extrapleural pneumonectomy (EPP) or pleurectomy/decortication (P/D); and the future of mesothelioma treatment.

Shah and Stacey Su, M.D., handle the majority of the mesothelioma surgeries at Fox. Both trained in Boston at Brigham and Women’s Hospital under renowned mesothelioma specialist David Sugarbaker.

Fox Chase, which is part of the Temple University Health System, is lauded for its multimodality treatment approach for multiple cancers, including mesothelioma. It is known as a pioneer in lung cancer treatment advances, and it’s now focusing more on asbestos-related cancers.

“I think it’s fair to say we’ve got it all here at Fox Chase,” Scott said. “The care that you’ll receive is better than ever. With mesothelioma, you need an experienced team that understands this disease, and we have that.”

Conference Addresses Numerous Issues

The conference at Fox Chase also included a segment on “State of the Art: Robotic Surgery for Complex Thoracic Cases,” by Robert Cerfolio, M.D., from the University of Alabama at Birmingham. He has used robotics extensively for more than a decade, though not necessarily for mesothelioma surgeries.

“Robotics is the future of surgery,” Cerfolio said. “Change isn’t always easy, but it’s about doing what is right for our patients.”

Radiation oncologist Kenneth Rosenzweig, M.D., who handles many of the mesothelioma cases at Mount Sinai Hospital in New York, spoke on “Novel Radiotherapy Approaches for MPM.”

He, too, talked about the importance of experience when treating mesothelioma, a rare cancer that is diagnosed in an estimated 3,000 people annually in the U.S. It is particularly important now with the latest Intensity Modulated Radiation Therapy (IMRT), which is used in combination with both aggressive surgical options and for patients who are not surgical candidates.

IMRT — if delivered correctly — kills remaining tumor cells and reduces the risk to surrounding healthy tissue and nearby organs.

Rosenzweig also talked about the latest pre-surgery radiation done in Toronto with patients undergoing the aggressive EPP, which removes an entire lung. Neither Mount Sinai nor Fox Chase is using that radiation approach yet, but they are following it closely.

He was optimistic, yet cautious, when discussing the future of mesothelioma treatment. He is now seeing patients he first treated four, five and six years before. People are living longer than ever.

“My personal approach [to treatment], has evolved. It’s tough with this disease to say we’ve had any big victories or that we’ve figured it out, but things are getting better,” Rosenzweig said. “We’re seeing successes.”

Conferences like the one at Fox Chase, where novel therapies and recent advancements are discussed, are helping the cause. There also were presentations on immunotherapy, molecular testing and palliative care, all designed to help medical professionals help their patients.

“There still is a long fight ahead,” Shah said. “But we’re moving in the right direction.”

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