Mesothelioma Treatment Options w Dr. Sugarbaker baylor

David Sugarbaker

David John Sugarbaker baylor (August 5, 1953 – August 29, 2018) was an American physician who was Chief of the Division of General Thoracic Surgery and the Director of the Baylor College of Medicine Lung Institute at CHI St. Luke's Health–Baylor St. Luke's Medical Center in Houston, Texas.[1] He was an internationally recognized thoracic surgeon specializing in the treatment of mesothelioma, the surgical management of malignant pleural mesothelioma, and treatment of complex thoracic cancers

Joe : it's a pleasure to be here with a man of so many talents and titles that you have particularly in the area of cancer treatment and your work on mesothelioma the last 25 years my legal practice I've been dealing with asbestos related diseases and with me some thinking almost particularly and know that that's a specialty that you develop you're the director of the International mesothelioma program 

Dr. Sugarbaker baylor : I started practiced at the Brigham and began to see a fair number of mesothelioma cases certainly because of the shipbuilding industry here around New England and with that we began to try to figure out some effective treatments there really wasn't a standardized treatment for mesothelioma and I really relied on something my father told me he was a cancer surgeon he said David's two steps first step take out all the tumor you can see step to eradicate the rest of it the microscopic disease and the International mesothelioma program was begun back in 2002 as a way of putting together all the areas of progress that had happened across the Harvard Medical School and across the Brigham together as a coordinated program focused on the patient and the research that would benefit the patient and also a support program to help the patient and their families get through what is a difficult time.

David Sugarbaker

Joe : your patients aren't just people that live in the Boston area you accept patients from all over the country tell me how if I have a client that's in Indiana or Louisiana or Wyoming tell me how they find out about you and your research and your progressive treatment of mesothelioma 

Dr. Sugarbaker baylor: the website is Brigham and Women's dot o-r-g and when they get to that website they'll see the InP they can click on it and go right to a very comprehensive web page that will acquaint them with the InP there's a number of stories there by patients themselves who've been through the program and the talk a little bit about what they went through and how life's been afterward so it's a comprehensive website and I think patients and their families will really benefit from looking at that 

Joe : When one is diagnosed what should they do well 

Dr. Sugarbaker baylor : Number one try not to panic okay try to remain calm and realize that mesothelioma is not the death sentence that it was 20 years ago there is effective therapy and for the majority of patients who are deemed candidates for an aggressive treatment strategy quality life extension is possible and so I would let people realize that we're going to take it a day at a time and number one let's get into a treatment program either here or elsewhere in the country that will allow experienced physicians experienced in the treatment of mesothelioma approach them as patients in a way that is knowledgeable and aggressive

Dr. Sugarbaker baylor : Back in the 1980s when I was first trying asbestos cases when I would talk to a family that had just received a diagnosis of mesothelioma the first thing that they felt in the first experience they had was that I have a terminal disease I have a fatal disease and it was sort of like they didn't have hope but I don't know that that's the case today in mesothelioma there are a lot of positive things that can be done medically the goal of our program for the program in general and its research in treatment efforts as well as for each individual patient is the following quality life extension leading to a cure quality life extension is available for the majority of patients who are deemed candidates for this aggressive treatment strategy and when I say leading to a cure we do have patients now that are 10 12 15 years out overall the 5-year survival of mesothelioma has risen dramatically over the past two decades and patients should know that that mesothelioma is not necessarily a death sentence and patients have done it as I tell the patients you know we can't go around this problem but we can go right through it we have a roadmap through it and others have blazed a trail ahead of you so number one I tell patients don't panic let's get a good look at your medical situation and see what can be done but it certainly isn't hopeless now 

Joe : When I first started practicing law and the majority of the clients that I dealt with had their asbestos exposure through heavy industrial exposure or military service and all and that's where we found a lot of the asbestos exposure and we still find clients that have asbestos Rea disease from those sources but it seems that when you talk to people today that are victims of mesothelioma the exposures come from a lot of different types of work areas school exposures family exposures what's been your experience with that as it relates to the disease and the progress of that you can make in treating the disease 

Dr. Sugarbaker baylor : We would see probably 80 to 90 percent of our patients in the late 80s knew where they were exposed to asbestos because then every patient who comes through we take a little questionnaire to figure out where they think they might have been exposed and what their occupation was now only about 60 percent know where they got it which means forty percent of patients are getting their exposures more likely more briefly but nevertheless as effective and causing mesothelioma is some of the ones that you mentioned refrigeration and so forth we're seeing a large number of individuals who have either dealt with breaks we've seen people from schools and just a variety of different work areas that really need to be looked after I mean the composite wall industry a lot of individuals from that and others that we never saw before 

Joe : doctor over the 25 years I've been litigating mesothelioma cases a long time job well we've been doing this a long time unfortunately there's a lot of asbestos disease that's occurred and continues to occur but one of the things that you know from a legal point of view we must know is is it really mesothelioma 

Dr. Sugarbaker baylor: Joe you touch on a very very important point as a matter of fact it's our first task when a patient comes here for evaluation and that is to answer the question as affirmative ly as we can one way or the other do you have mesothelioma and we have a panel of pathologists here who will review the path from the hometown hospital which we ask the patients to either bring with them or send along ahead of time and they'll do what's called immune histochemical staining and other tests to be as sure as a humanly possible that that is what you have 

Joe : Talking about new treatments I've heard you speak several times and you've come to our law firm and and help educate our lawyers as they're dealing with these issues in the court room and you've talked about hot chemo therapy and can you tell me just in a layman's term what that is and what that process is 

Dr. Sugarbaker baylor : after mesothelioma is removed from our studies we understand that the most likely place that may come back is just where we took it out so even though we don't see any cells left behind that's where they tend to recur and so we've focused radiation and that way after surgery and intravenous chemotherapy but over the last decade we've developed a technique where we instill in the chest at the time of surgery after the tumor has been removed chemotherapy initially a single drug to prove its safety and now we have a double drug and soon be hopefully be having a triple drug therapy regimen that is meant at the time of surgery to eradicate as much as possible these remaining microscopic cells and we feel that the future for this type of treatment is very bright and it's really established a new platform a new type of therapy that mesothelioma patients can benefit from

Joe : and you do that while the surgery for removing the cancer to start with is taking place 

Dr. Sugarbaker baylor : that's right so once the surgeries but what's the surgery to remove the tumor which may either be removing the tumor off the lung what's called a pleura to me or it might be actually removing the entire lung the extra pleural pneumonectomy either one of those procedures as long as it reduces the disease to a microscopic level of me and we can't see any left is a starting point to then at that time during the surgery but after the removal to give the heated chemotherapy usually for an hour that's cutting-edge that's cutting-edge

Joe :  I'm gonna brag on your family a little bit because as I'm sitting here with dr. David sugar breaker Sugarbaker you have a brother I think it's Paul yes it's down in the DC area and he's also dedicated his professional career to did him with me something glioma but he deals mainly with parents and tell me something Elmer's as I understand 

Dr. Sugarbaker baylor : it that's right he is a more of an abdominal surgeon and has taken this on and we've learned a lot from him and from his research 

Joe : So you both learned a lot from your death that's exactly right 

Joe ; one of the interesting things that I know you do it's your session with your patients is you bring a survivor of this ├Âthey glioma in that you've treated here that that has been part of your program and they talk to the patients and tell them you know whatever they may tell well you share some of the the concepts some of the the things that those survivors have said about the disease and about fighting the disease

Dr. Sugarbaker baylor : Well I would say that when an individual who's been through the surgical treatment the interoperative chemotherapy and whatever l of treatments we may recommend after that when they come in the room they can transfer more information and more hope in a minute of talking than I can over the course of the hour because there's nothing like talking to someone who's been through the process and who can stand there and say I'm two years out I'm three years out and this is what you're going to face and it's certainly surmountable and if you stick with the program and with the coaching you know there's a real chance to win an individual who's been through it who's standing there telling his or her story is a very effective way to let people know this is there is hope and that certainly it's not office 

Joe : dr. Sugarbaker in your efforts to promote the patient education what's the one thing that you can just tell a patient that they need to keep in mind as they're dealing with this disease 

Dr. Sugarbaker baylor : Well Joe that is anything is possible and long-term survival is possible it has been done before and is being done frequently at a number of different programs including ours and the five-year survival has gone from zero twenty years ago to really a substantial number of patients living five years the most important thing that patients need to understand is that they really need to get in a positive frame of mind and one of the things that we focus on this in this session before they're actually seen individually is the importance of that mindset a winning mindset and I like it at many times to some of the major sports like football you know if you were playing the Super Bowl and you didn't believe you could win that would be tough to win wouldn't it particularly the other side had a different idea out there in the world people say and you'll hear it all the time I'll believe it when I see it here in medicine many times it really is I'll see it when I believe it and getting into that frame of mind to understand that anything is possible is part of our overall strategy with the initial patient education many times talking to patients who've been through the program 

Joe : doctor I want to thank you for the time that you've given me today and I also want to thank you for the time that you've come down to Charleston and spent with my attorneys educating them on this Athenian line on what's the science is learning and to make them better lawyers in the courtroom for our clients and we do appreciate that and appreciate your time and efforts and we congratulate you on the successes you've had and wish you the best going forward with you and your colleagues here at Brigham and Women's thank you very much for all your support and for coming up here today we take every opportunity we can to help educate patients and what would be your clients with the possibilities and in this disease we now know anything is possible because we have patients who have even had bilateral disease alive five six years later so anything's possible we've got to stay positive you

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