Surgical oncologist W. Charles Conway didn't come to the Ochsner Cancer Institute in 2009 with the idea of becoming one of the national leaders in the treatment of peritoneal mesothelioma.
It just became a necessity.
Louisiana has one of the highest incidence rates for mesothelioma in America, a byproduct of the shipbuilding and shipping industries, and its blue-collar workforce. There was a vital need to improve the treatment for this rare cancer, and Conway stepped into the role.
While thoracic surgeon Dr. Brian Pettiford has taken the lead with pleural mesothelioma, Conway has been directing the care of the peritoneal cases. Together they are creating a specialized center for mesothelioma patients across the Gulf South region.
"There is a tremendous need here for mesothelioma expertise," Conway said. "With a rare cancer like this, it's incredibly important to find a center with the experience to handle it. Most surgeons don't want anything to do with it. As a (peritoneal) patient, you should find one with experience in complex, abdominal surgeries. We do a lot of them, and our outcomes are good."
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There are an estimated 3,000 mesothelioma cases diagnosed in the United States annually, and only about 20 percent of those are peritoneal, a cancer that can spread across the lining of the abdominal cavity and touch the nearby organs.
Mesothelioma is caused by the inhalation or ingestion of microscopic asbestos fibers, a naturally occurring mineral that was used in shipbuilding, construction and manufacturing throughout much of the 20th century.
Conway has worked with a wide range of abdominal cancers. He has done complex surgeries involving the pancreas, gall bladder, liver, bowel and esophagus. His clinical interests also include complex, upper-GI oncology surgery. His innovative approach to treatment has been invaluable at the Ochsner Cancer Institute.
In 2013, Conway performed the first totally robotic pancreaticoduodenectomy (Whipple procedure) in Louisiana. The robotic approach eliminates the need for a large abdominal incision, and shortens the recovery time.
He has been successful treating many peritoneal patients with a multidisciplinary approach that includes cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).
The surgery removes all visible signs of the cancer. It is followed by a heated chemotherapy solution that is pumped into the abdomen, then circulated for 90 minutes before being drained. The theory is that the heated chemotherapy bath can reach the microscopic cells that the surgeon couldn’t remove. It is more concentrated than systemic chemotherapy.
“These (mesothelioma) patients are in a tough spot, but you can make a difference for them with hard work and the experience we have,” Conway said. “It’s a difficult operation, and the post-operative care is difficult. But we are equipped to handle it well.”
Conway joined the Ochsner team in 2009. He did his surgical oncology fellowship at the John Wayne Cancer Institute in Santa Monica, where he first developed a strong interest in peritoneal malignancies. He did his earlier internship and residency at Wayne State University/Detroit Medical Center. He is board certified in general surgery. He is a member of the American College of Surgeons and the Society of Surgical Oncology.
Until early in 2013, Conway also was involved in diagnosing pleural mesothelioma cases at Ochsner, which provided insight into the prevalence of the disease in Louisiana.
“It made me realize the need for the program we now have in place,” he said. “I was amazed at how many pleural cases I was diagnosing.”
He also has taken a leadership role in researching even better ways to treat peritoneal patients, collaborating with other cancer centers, which is critical with a rare cancer like mesothelioma.
“We’ve seen significant progress made in treating this disease,” he said. “But there is still so much more we can do.”
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