Pleural and Lung Cancer
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Video-Assisted Thoracoscopic Surgery
Dr. David Sugarbaker of Baylor College of Medicine in Houston is known among his peers and patients as “Mr. Mesothelioma” because of his vast knowledge and innovative treatments such as multimodal therapy.
Thoracic surgeon David Sugarbaker, M.D., has moved almost 2,000 miles away from the renowned mesothelioma program he built in Boston, but his commitment to patients and fighting this cancer will be stronger than ever before.
Sugarbaker is now director of the Lung Institute at the Baylor College of Medicine in Houston, where he is building a multidisciplinary program that combines a mesothelioma research institute with an unmatched clinical practice.
Sugarbaker, who also is the chief of general thoracic surgery at Baylor, built his reputation through the previous 25 years at Brigham and Women’s. During his tenure at that hospital, he developed and refined the extrapleural pneumonectomy, an aggressive surgery that removes a cancerous lung, the lining around the lung and heart, along with nearby lymph nodes and a portion of the diaphragm.
His work as a surgical innovator helped lower the operative mortality rate, extended the lives of many patients and moved the mesothelioma community closer to finding a cure. Sugarbaker has earned the respect of his peers and patients, many of whom travel across the country, and from around the world, to be part of his work.
It’s an opportunity to take all that I’ve learned [in Boston] and do it on a bigger scale now,” Sugarbaker told Asbestos.com. “This is a chance to do something that could really benefit the entire mesothelioma community in a major way.”
– Dr. Sugarbaker
“He is Mr. Mesothelioma,” said fellow surgeon Abraham Lebenthal, who worked alongside Sugarbaker at Brigham and Women’s Hospital in Boston. “In this field, he is the gold standard. I don’t think you’ll get any argument on that.” As chief of the division of thoracic surgery at Brigham, Sugarbaker made this cancer the center of his focus for many years, pioneering the multimodal treatment approach that combines surgery with radiation and chemotherapy.
While in Boston, he founded and directed the International Mesothelioma Program, the largest of its kind. The program’s research, clinical and support divisions attracted medical staff and patients to Boston from around the world. He expects his efforts in Texas to have a similar magnetic effect, only on a larger scale, opening the door for new research efforts that could bring everyone closer to a cure.
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His laboratories have successfully identified specific gene ratios in tumors caused by this asbestos-related disease, helping us gain a deeper knowledge of the disease and its clinical subtypes. His efforts have led to personalized therapies for individual patients, moving away from the ineffective one-size-fits-all approach to treatment.
“We are in the midst of a worldwide epidemic of mesothelioma, both in the United States and in Europe, where the epidemic is not expected to peak until 2020,” he said.
Still considered one of the foremost experts on the disease, Sugarbaker was involved in the early studies of frozen samples of mesothelioma, which identified particular molecular markers that are specific to the disease. The findings aided the search for earlier diagnosis among patients who have been exposed to asbestos the only known cause of the illness.
Sugarbaker attended Cornell University Medical School. He completed his surgical residency at Brigham and Women’s and his cardiothoracic training at Toronto General Hospital. He returned to Brigham as a surgeon in 1988, opening the door to his interest in the asbestos-related cancer.
He is published extensively in various medical journals for his work toward extending the lives of mesothelioma patients and giving them more hopeful treatment options.
Sugarbaker’s interests also include general thoracic surgery, video-assisted thoracic surgery, minimally invasive surgery, lung volume reduction surgery, non-small cell cancer and esophageal cancer.
It was no accident that David Sugarbaker, newly-appointed director of the Lung Institute at Baylor College of Medicine, became one of the world’s most noted authorities on mesothelioma.
He was born and raised into it.
Sugarbaker was one of 10 children, five of whom became doctors. Growing up in Jefferson City, Missouri, they would listen to their father talk passionately every night about the need to help those with cancer.
That was almost 50 years ago.
The challenge of cancer was a daily discussion at our dinner table. He was a surgeon. And he never quit trying to find better ways to help his patients. It was an inspiration for me at a very young age,” Sugarbaker told Asbestos.com. “He played a big part in this.”
– Dr. Sugarbaker
Sugarbaker, who founded the acclaimed International Mesothelioma Program (IMP) in Boston in 2002, turned some of his early life lessons into a career that has played a major role in improving the treatment of those afflicted with this deadly disease.
His preparation for battling mesothelioma didn’t start at Cornell University Medical College, where he graduated in 1979, or when he arrived at Brigham and Women’s Hospital in 1988. It started at home long before, listening to his father, working on the family’s 16-acre apple orchard in Jefferson City, along with all those brothers and sisters.
“There is a lot of work to do in the winter, spring and summer when you’re running an apple farm, and very little positive reinforcement,” he said. “You have to have faith that there will be a return [in the fall]. The ability to work a long time without anything positive, that’s something I learned at home. You had to believe. It played a very significant role in my outlook [with mesothelioma].”
Despite the history of frustration and disappointment, there still is no cure for mesothelioma.
But Sugarbaker believes there is now hope for one in the future. It’s one of the reasons he left a comfortable position in Boston to build a Lung Institute in Texas that will include a Mesothelioma Research Institute designed to move closer to a cure. He expects it to become bigger and better than the IMP, which already combines a state-of-the-art clinical research facility with a multimodality treatment approach. In Texas, he will have more resources available.
Sugarbaker left Boston in 2014, leaving behind a program that should continue to thrive under new leadership. He has turned his attention and leadership skills to Texas, where he hopes to have similar success with mesothelioma and other lung diseases.
“As I say to patients, when hope is part of the equation, anything is possible,” he said. “I remain optimistic that we can, in the next decade, put together the right combination of patients and treatments to effect a cure, which is our holy grail.”
Sugarbaker immersed himself in the cancer fight upon his arrival at Brigham and Women’s. The nearby shipyards around the Boston area, and the longtime exposure to asbestos there, had produced an inordinate amount of mesothelioma patients for him to handle. And they were dying quickly.
“Early in my career, it was laid at my doorstep,” he said. “And I took it as a challenge. Although it was a difficult cancer to treat, with relatively poor outcomes, you had to stick with it. When we started making significant strides, I was drawn to that.”
The IMP grew rapidly, attracting some of the brightest and best from a variety of fields, drawn by the collaborative approach of an international program directed by Sugarbaker. He hopes the same can happen at Baylor.
“I tell them [young doctors] that this disease before us is like a block of solid granite,” he said. “To try and break it, you can swing a broad pick and get nowhere. Or you can narrow your point and chip away at it. Make progress. Narrowing your focus is one of the keys.”
Sugarbaker still finds motivation within the success stories of his patients, taking pride in every small step that is taken toward the goal of finding a cure. He also believes that quality life extension is the road to reaching it.
“There are people now more than 10 years out [from diagnosis of mesothelioma]. There are multiple ones three to five years out,” he said. “When you’re staring mesothelioma in the face and given six months to live, then seeing others a few years out, hope springs up. The fact that someone has gone through it, done it, speaks louder to patients than anything I or other so-called experts could say.”
Sugarbaker’s peers and patients view him today as a leader in the field. He often serves as a featured speaker at various cancer seminars, and even appeared in an episode of ABC’s “Boston Med” that featured the treatment of a mesothelioma patient.
Yet, he also still reverts back to his earlier days, listening to his father, who would come home talking about his patients and the motivation they provided.
“Rather than take pride in what we do, there is really more a sense of amazement with these patients,” he said. “People are told there is no hope, yet they are willing to plow forward, looking for answers. Their courage never seems to wane. That’s inspiring to me.”
Disclaimer: Dr. David Sugarbaker has no professional affiliation with Asbestos.com.
Tim Povtak is an award-winning writer with more than 30 years of reporting national and international news. His specialty is interviewing top mesothelioma specialists and researchers, reporting the latest news at mesothelioma cancer centers and talking with survivors and caregivers.
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