There is a good reason why the number of malignant pleural mesothelioma patients is rising in the office of thoracic surgeon Dr. Kemp Kernstine at the UT Southwestern Medical Center in Dallas.
He is giving them hope.
Kernstine, who specialized in all lung diseases, is in his fourth year at UT Southwestern, and several of his earliest mesothelioma patients still are returning for follow-up visits, a testament to his success in treating asbestos-related cancers.
We have patients who are years out from diagnosis, and they are functioning fine today,” Kernstine said. “They are doing really well. And that tells us something.
The number of survivors who have passed through his office has grown to the point where a local mesothelioma support group is forming, allowing patients to meet regularly and discuss various issues, hopes and concerns.
“We’ve seen an increase in the number of cases coming our way. We’ve got a staff trained in handling these complex cases, and we’re having success. We’d like to help more of these patients who really need to see a specialist.”
The life expectancy of a mesothelioma patient nationally is still in the 6-18 month range. It’s considerably higher among the patients handled at UT Southwestern.
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As chair of the division of thoracic surgery, Kernstine is experienced in pleurectomy/decortication (P/D) and extrapleural pneumonectomy (EPP), the two most aggressive surgeries for mesothelioma patients.
Although Kernstine oversees the surgical management of the disease, he believes that future progress in treatment will involve major advances in the laboratory, where better drugs and systemic delivery of those drugs is being made.
It's one reason he came to UT Southwestern Medical Center, which is doing extensive research in various lung diseases, including pleural mesothelioma.
There is quite an intensive research machine here," he said. "It's an amazing place, and it's what drew me here originally. It's really an incredible place. We're at the center of quite a number of things. Discoveries are going to be made here.
Kernstine, 59, previously worked at the University of Iowa Hospitals and Clinics, and at the City of Hope National Medical Center in California. He graduated from Duke Medical School and trained as a thoracic surgeon at Brigham and Women's Hospital in Boston, where he first worked with mesothelioma.
"As far as curing this disease, I don't know if you'll see that surgically," he said. "I think we'll discover new maintenance drugs to provide long-term solutions. I don't necessarily believe we'll cure it, but we'll be able to control the disease, and keep it contained."
Kernstine's clinical interests go well beyond mesothelioma and other asbestos-related diseases. Among his interests are:
Kernstine also is well known for his extensive work with robotic and other minimally invasive surgeries. He is credited nationally with performing several firsts in robotic chest surgery, including the first published robotic oncologic esophagectomy in the world.
He is lauded for his successes as one of the highest volume robotic thoracic surgeons in the country, allowing patients to recover quicker and with less pain than with traditional surgeries.
Although robotic surgery has yet to significantly impact mesothelioma surgery, it underscores his philosophy of performing the highest quality procedures with the least pain and fewest mental and physical side effects for patients.
Part of my team's patient-care philosophy is always thinking outside the box," he said during a UT Southwestern website question and answer session. "Don't just take what's presented to you. Treating cancer takes teamwork, asking questions, listening to the patient.
He listened to one mesothelioma patient not long ago who had been to another cancer center in Texas, where he was told there was little anyone could do for his condition, and that there was no hope for the future. Kernstine told him otherwise.
"Here in this region [of the country], many surgeons haven't seen patients like this. It's a rare cancer. They'll often tell a patient, nothing can be done. It's terminal diagnosis," he said. "He was elated when he found out that something could be done, that he could be functional again. There is hope out there."
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