Treatment & Doctors

Doctors Helping Veterans with Mesothelioma Access the VA Health Care System

Written By:
Jun 04, 2014
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Written By: Tim Povtak,
June 4, 2014

The West Los Angeles VA Medical Center can provide some of the finest care in the world for patients with malignant pleural mesothelioma.

The problem is that not enough veterans – or even the doctors throughout the sprawling Veterans Administration health care system – know it’s available.

“One of the biggest challenges we face is trying to get the word out, to make people aware of what we have here,” said Graciela Hoal, RN, NP, who works closely with doctors and patients at the West Los Angeles VA. “The care we offer can make a big difference for a patient with mesothelioma.”

In an effort to spread the word, Hoal will be speaking Saturday afternoon in Santa Monica at the 4th annual International Symposium on Lung-Sparing Therapies for Malignant Pleural Mesothelioma. Her topic is “Mesothelioma Among Veterans: The Benefits and Challenges Experienced at the World’s Largest Health Care System.”

The catalyst behind the symposium is renowned surgeon Robert Cameron, M.D., director of the UCLA Mesothelioma Comprehensive Research Program, and chief of thoracic surgery at the West Los Angeles VA. Cameron has been a pioneer in the treatment of mesothelioma for the last 20 years.

While the U.S. Department of Veteran Affairs overall is under attack these days for rampant mismanagement and falsified recordkeeping that led to the recent resignation of VA Secretary Eric Shinseki, Cameron’s work with patients is one of the shining lights within the system.

Cameron Offers Veterans Hope

“Veterans are very lucky to have Dr. Cameron in the system,” Hoal told “A lot of doctors have little or no experience with mesothelioma.The life expectancy, where there is not a specialist, can be six to nine months. But we have patients we first saw in 2008 who are living fairly healthy lives today. A great specialist can make a difference.”

Mesothelioma is a rare and aggressive cancer diagnosed in an estimated 3,000 Americans annually. It is caused almost exclusively by exposure to asbestos, which once was used extensively by the U.S. Armed Forces for its ability to strengthen and resist heat. That reliance on the toxic mineral is a big reason why a disproportionate number of veterans (almost one-third), compared to civilians, are diagnosed with the disease.

Cameron is one of only two thoracic surgeons within the VA system who specialize in this asbestos-related cancer. Abraham Lebenthal, M.D., in Boston is the other. Both have tried to spread the word of their availability throughout the system, but have been frustrated with the results.

Once in the VA system and in possession of a referral from the local VA office, a veteran anywhere in the country with mesothelioma can travel and receive care from a specialist like Cameron or Lebenthal.

The West Los Angeles VA approved the Admiral Zumwalt Mesothelioma Specialty Program in 2013. Yet very little has been done nationally by the VA to promote the program. There are more than 150 hospitals and almost 1,000 clinics within the VA system, but only a fraction know how to handle or where to refer a patient diagnosed with the disease.

Cameron has seen mesothelioma patients at the West Los Angeles VA from California, Oklahoma, Arizona and Iowa, but not as many as he would like – and not nearly as many who could use his help.
Cameron is the foremost expert on the lung-sparing, pleurectomy/decortication surgery, developing a multimodality treatment plan that incorporates resources from the Pacific Meso Center, the UCLA Research Program and his local VA.

New Therapies Are Helping Veterans

At the West Los Angeles VA, Cameron utilizes mesothelioma specialists in radiology and chemotherapy. He’s had considerable success with novel interventions like Betadine Lavage Therapy, immunotherapy and cryoablation, a minimally invasive procedure that uses controlled freezing to dissipate small cancer tumors.

Cameron has examined records and made recommendations virtually via computers for patients and physicians outside his area, but can only do so for those who are aware of his services.
“This is not a situation unique to the VA System,” Hoal said. “A lot of times, oncologists and pulmonologists are telling patients there is nothing they can do [for mesothelioma patients]. Patients are just being told to get their affairs in order. But there are new therapies now that can help them if they get to a true mesothelioma care center.”

At the Santa Monica symposium, Hoal will be joined by a distinguished international faculty that includes Jan P. van Meerbeeck, M.D., at Antwerp University Hospital in Belgium; Percy Lee, M.D., chief Thoracic Radiation Oncologist at UCLA; Joachim Aerts, M.D., at Erasmus MC Cancer Institute in the Netherlands; Richard Lemen, Ph.D., former Assistant Surgeon General of the United States; and Olga Olevsky, M.D., of the UCLA Medical Center.

The symposium is for physicians, medical students, nurses and other health care professionals wanting to hear about the latest advances in mesothelioma research and therapies. Mesothelioma patients, families and advocates also will be attending.

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