List of Doctors for Mesothelioma

This is a list of doctors who treat patients with
mesothelioma. Their appearance on this site is not a recommendation. You should treat these doctors as you would any unknown doctor and ask many questions about your experience with other patients with mesothelioma.



Manjit Bains, M.D., F.A.C.S
Memorial Sloan Kettering Cancer Center
New York, New York
Tel. 212-639-7450
Dr. Bains is board certified in Surgery and Thoracic Surgery and has clinical expertise in mesothelioma. For more information,


David J. Sugarbaker, M.D.
Brigham and Women's Hospital, Division of Thoracic Surgery
Boston, Massachusetts
Tel. 617-732-6824
Dr. Sugarbaker is Chief of the Division of Thoracic Surgery at Brigham and Women's Hospital. Malignant pleural mesothelioma has been a central focus of Dr. Sugarbaker's clinical and laboratory research.


Graeme L. Hammond, M.D., F.A.C.S.
Yale University School of Medicine, Department of Surgery
New Haven, Connecticut
Tel. 203-785-2704
Dr. Hammond is a professor with the Department of Surgery at the Yale University School of Medicine in New Haven, Connecticut. He is board-certified in surgery and thoracic surgery.


Theirry Jahan, M.D.
UCSF Comprehensive Cancer Center
San Francisco, California
Tel. 415-567-5581
Dr. Jahan is an associate clinical professor of medicine at UCSF. He specializes in the treatment of lung cancer, mesothelioma, sarcomas and endocrine tumors and the use of multiple treatments.


David Jablons, M.D.
UCSF Comprehensive Cancer Center
San Francisco, California
Tel. 1-800-888-8664 or 415-885-7777
Dr. Jablons is the Professor and Chief of the Section of General Thoracic Surgery at UCSF. He is Board Certified in General Surgery and Thoracic Surgery.



Valerie Rusch, M.D., F.A.C.S
Memorial Sloan Kettering Cancer Center
New York, New York
Phone: 212-639-5873
Dr. Rusch is a surgeon who treats patients with cancers of the lung, esophagus, mediastinum, and chest wall, including those with mesothelioma. She is board certified in surgery and thoracic surgery

Dr. Brian Loggie
Creighton University School of Medicine
Omaha, Nebraska
Tel. 402-280-3273
Dr. Loggie is a Professor of Surgery, Chief of the Division of Surgical Oncology, and Director of the Cancer Biology Program at Creighton University School of Medicine. His special interest include: Peritoneal carcinomatosis and malignant ascites, and peritoneal mesothelioma.

Robert B. Cameron, M.D.
UCLA Medical Center
Los Angeles, California
Tel. 310-794-7333
Dr. Cameron is the Director of Thoracic Oncology at UCLA Medical Center. He is board-certified in general surgery and cardiothoracic surgery. His research interests include lung cancer, esophageal cancer and mesothelioma.

Mesothelioma Malignant

Paul Kraus is the only long-term survivors of malignant mesothelioma. There are others. We have listened and talked to a couple of years. What is fascinating is that many of these families malignant mesothelioma has something in common - all have tried to increase or enhance the immune system. Some people use complementary or alternative therapies (led by licensed physicians), while others participated in clinical trials of immune therapy.

This raises the question - the immune system plays a role in the control of malignant mesothelioma? Paul Kraus, experience and other long-term survivors of malignant mesothelioma suggests that this role may be possible. In other parts of this site, we present case histories of malignant mesothelioma survivors who were diagnosed with pleural mesothelioma or peritoneal mesothelioma is. In some cases of pleural mesothelioma stories, doctors discuss the role of the patient's immune system may have played in their survival very long.

A 1986 medical journal article that reviewed the same number of malignant mesothelioma and immunity. (1) This research focused on immune responses of 118 healthy people, compared with 20 patients with malignant mesothelioma and 375 asbestos workers who were long-term cancer-free. The researchers wanted to know if there were significant differences in the immune response of patients with mesothelioma. The results showed a relationship between the immune system and malignant mesothelioma. For example:

The total number of T (T11 +) and T-helper (T4 +) tumor cells were normal in asbestos workers, but were significantly reduced in patients with mesothelioma. T cells orchestrate, regulate and coordinate the entire immune response.

· The majority of patients with mesothelioma had a profound lack of natural killer (NK), which emphasizes the role of the immune system plays the control of malignant mesothelioma. NK cells are lymphocytes, a type of deadly cancer cells target and protection against a wide range of infectious microbes.

In the discussion section of the report, the researchers:

"These results led us to speculate that biological phenomena generally classified as chronic immunosuppression associated with the presence of workers exposed to asbestos may have caused the failure of the control system of the machine and the development of neoplasia [malignant mesothelioma]. "

In other words, the scientists suggest that malignant mesothelioma may result from immunosuppression. If true, it would be the biological basis for the role of the immune system and immune system approaches can play in improving the management of malignant mesothelioma.

Endnotes

(1) Lew, F., et al, high frequency of immune dysfunctions in asbestos workers and in patients with malignant mesothelioma Journal of Clinical Immunology. 1986, 6:03, 225-232.

Radiography

Radiography

Mesothelioma most commonly found on radiographs is unilateral pleural thickening or nodular concentric plaquelike (as seen in the pictures below). Pleural effusions are common and can mask the presence of underlying pleural thickening. The tumor often extends into the cracks, which thickened and irregular in outline. A slight predominance of right side is observed, probably due to increased pleural surface. The tumor can be wrapped securely to the lungs, causing pulmonary parenchymal compression, elevation of the diaphragm, intercostal space narrowing, and mediastinal shift toward the tumor. Calcified pleural plaques are present in 20% of patients with mesothelioma and are usually associated with previous exposure to asbestos.


Man, the Image of the lung and 65 years, on the left side of chest pain, and biopsy tested for mesothelioma. On the left side pleura is thickened and lobulated, which is often observed in mesothelioma.


Chest radiograph of a patient aged 58 with mesothelioma and shortness of breath. This image shows diffuse left pleural thickening, pleural effusion and volume loss ipsilateral.

Pulmonary nodules and hilar masses usually the result of the mesothelioma tumor extension directly into the lung parenchyma and mediastinal structures, such as the lymph nodes, pericardium and heart. Mechanical deformation of the hemithorax, the masses of the chest wall, rib periosteal reaction, or destruction of the tumor chest are signs of advanced disease. However, usually unilateral, direct extension of the tumor through the mediastinum in the contralateral hemithorax occurs.

Confidence


Although the definitive diagnosis can be made on the basis of X-ray results, the new unilateral pleural thickening or effusion in a patient with a history of asbestos exposure is highly suggestive of mesothelioma.

Pathophysiology

Pathophysiology

The three main histological types of mesothelioma are sarcomatous, epithelial, and mixed. Pleural mesothelioma usually begins with discrete plaques and nodules that together to produce a sheet like the neoplasm. Tumor growth usually begins in the lower chest. The tumor can invade the diaphragm and the frame surface of the lung and interlobar fissures.

The tumor may also grow along drainage ways and thoracotomy. As the disease progresses, often extending into the lung parenchyma, chest wall and mediastinum. Pleural mesothelioma can spread to the esophagus, ribs, vertebrae, brachial plexus and the superior vena cava.



Asbestos, amphibole, crocidolite, amosite and, in particular, is the principal carcinogen implicated in the pathogenesis. Exposure to chrysotile asbestos is associated with a low incidence of mesothelioma. The asbestos-related industries are mining shipbuilding involving the use of asbestos, asbestos-cement manufacturing, ceramics, paper making, automotive parts (brake linings and asbestos), repair of railways, and isolation. In Turkey, the use of the substance fibrous erionite (similar to amphiboles) in construction has led to an epidemic of mesothelioma lung cancer. Environmental exposure to asbestos in areas contaminated by the substance may increase the incidence of mesothelioma.

Most malignant mesothelioma have a complex karyotype with extensive aneuploidy and transformation of many chromosomes. Loss of one copy of chromosome 22 is the most common abnormality.

Mesothelioma is a malignant pleural or peritoneal surfaces, this condition is usually associated with occupational exposure to asbestos. Wagner et al linked to asbestos mesothelioma classic 1960 study, 33 patients with mesothelioma who were exposed to asbestos in the mining area of ​​South Africa's Northern Province Western Cape. [1], 33 patients, 32 had been exposed to crocidolite, most of the type of asbestos cancer.


Asbestos mining and production peaked from the 1930s-1960s, and asbestos was used in a variety of products ranging from construction supplies to brake linings. During World War II, hundreds of thousands of civilian and military workers, through their occupations, were exposed to asbestos. Production slowed dramatically in the 1970s as the health risks of asbestos became known. Governmental restrictions were placed on its use, and alternative materials became available. Despite these changes, asbestos continues to be used in the manufacture of some fire safety products.


The clinical latency period between asbestos exposure and mesothelioma development is 35-40 years, and as a result, the number of mesothelioma patients has continued to rise despite decreased asbestos production. The most common findings on physical examination (79%) are signs of pleural effusion (eg, dullness to percussion, decreased breath sounds).

The diagnosis of mesothelioma should be done with care. A history of asbestos and radiological findings are consistent with mesothelioma justify inclusion in the differential diagnosis, but it is important that the diagnosis of mesothelioma can be done only with imaging studies. The most common diseases such as benign asbestos-related pleural metastasis of adenocarcinoma, may look identical to a radiographic mesothelioma. Biopsy with special stains and immunohistochemical and ultrastructural analysis are absolutely essential for the accurate diagnosis of mesothelioma.


Mesothelioma is very difficult to treat, treatment is usually surgical, although other treatments such as chemotherapy and radiation used. The two main surgical pleurectomy and extrapleural pneumonectomy (EPP).

Preferred examination

Chest radiography is the initial screening study, while computed tomography (CT) is preferable for the staging of the tumor.

Magnetic resonance imaging (MRI) to complete the CT in some patients. MRI provides a better definition of soft tissue (better soft tissue contrast) and allows the imaging of sagittal and coronal planes. [3]

PET can also be useful in delineating the extent of tumor or metastases [4].

Limitations of techniques

Chest radiography has a limited applicability. The radiological signs of mesothelioma are nonspecific and seen in other diseases, including metastatic carcinoma, lymphoma, asbestos disease and Benin. Small malignant pleural effusion is not visible on plain radiographs. Alternatively, large pleural effusion or pleural thickening dark mass, and therefore, since the disease is often underestimated in radiographs.

CT scans are more and better than plain radiography in relation to tumor characteristics and extent. Although MRI is superior to CT scanning in some areas, this advantage has not changed the surgical treatment in a study by Heelan et al. [5]

Neither CT and MRI provides an unequivocal diagnosis of mesothelioma, a biopsy is needed to diagnose the final fabric.

Mesothelioma Treatment

Mesothelioma Options Treatment

Cancer treatment usually focuses on the destruction of malignant cells and preserving healthy ones. This can happen in several ways. At present, patients typically use three primary mechanisms for the treatment of mesothelioma. Either surgery, radiotherapy and chemotherapy, or a combination of three is considered the most effective for the treatment of malignant mesothelioma. What treatment is recommended will depend greatly on these topics:

Surgery for Treatment Mesothelioma

Surgery can be performed mesothelioma patients for two reasons: to try to cure the disease or palliative reasons to maintain patient comfort and improve the quality of life. Because mesothelioma is almost always diagnosed in later stages, curative surgery is usually not an option. When the tumor has metastasized outside the pleural cavity, the relief is usually only a witness in which the intervention is used.

As tests are developed that can help diagnose mesothelioma at an early stage, surgery may be a possibility in the future. At that time, doctors may be able to try to remove the cancer and some surrounding tissue in an attempt to stabilize the disease.

However, surgery is most often used in palliative measure. For example, doctors may choose surgery called pleurisy, which involves injecting talc into the lungs to prevent the return of the fluid. Amniocentesis, a surgical procedure to remove fluid in the lungs using a thin needle, may be recommended

In severe cases, a lumpectomy is recommended for palliative care. This involves the removal of the pleura - the lining of the lung - and can control the accumulation of fluid and reduce the pain and difficulty breathing.

Advancements in Mesothelioma Surgery

In recent years, doctors have made some of the clinics that have large cuts leading cancer survival rates for a long time for those diagnosed with early-stage disease. Among the exciting aspects of these treatments is the so-called extra pleural tonsillectomy. This procedure, which requires the expertise of leading surgeons mesothelioma, surgery dimension affects the lungs, lumpectomy, removal of the pericardium (membrane that surrounds the heart) and diaphragm. During surgery, intro-operative chemotherapy (eg cisplatin and Gemzar) is applied directly onto the affected area to remove all remaining malignant cells. After the application of chemotherapy, the diaphragm and the pericardium was reconstructed with prosthetic material.

Radiation Therapy for Treatment Mesothelioma

If a patient's health is too fragile for surgery or chemotherapy, radiotherapy is often recommended. The radiation is associated with fewer side effects and are generally more tolerable than chemotherapy for the treatment of mesothelioma. There are a few different methods of radiation treatment available to mesothelioma patients. Radiation is often used in conjunction with another type of treatment, as additional capacity to existing chemotherapy.

External radiation therapy - the preferred form for the treatment of mesothelioma, this kind of radiation comes from a machine outside the body and is the affected areas. Usually, five days a week for 5 weeks, this type of radiation is often used for palliative - to reduce respiratory problems, pain, bleeding or difficulty swallowing - but rarely showed the true power as a curative treatment of mesothelioma. This type of radiation can also be used as an adjunct to surgery.

Brachytherapy - rarely prescribed for mesothelioma, as the radiation places radioactive material directly into the lungs and stomach.



Chemotherapy for the treatment of mesothelioma

AOther drugs given to patients to combat the unpleasant side effects of chemotherapy, such as medicine to relieve nausea and vomiting or vitamins to replace those lost essential during chemotherapy. Some patients, for one reason or another to make an informed decision about the side effects of chemotherapy are too serious and chooses not to receive this treatment.

s radiotherapy, chemotherapy offers no cure for mesothelioma, but can be very effective in providing relief from severe symptoms of the disease. As researchers continue to try different combinations of chemotherapy drugs, patients will continue to receive their results. Hops are one day chemotherapy drugs can go much further by extending the life of a patient and develop a cure for mesothelioma.

Chemotherapy drugs, in general, is either ingested in pill form or injected into the patient systemically. In cases of mesothelioma patients, the drugs administered intravenously. The doctors generally combine two drugs for the best results. We will serve the primary cytotoxin and another will serve as an alkalizing agent to stabilize the surrounding healthy cells. Currently, the only combination that is approved by the Food and Drug Administration is Alimta ® (pemetrexed) and cisplatin ®, but other drugs are used in tandem if deemed preferable to a specific patient participating in a clinical trial. In some cases, patients can not tolerate a single substance, while only one is used for treatment.

Other drugs given to patients to combat the unpleasant side effects of chemotherapy, such as medicine to relieve nausea and vomiting or vitamins to replace those lost essential during chemotherapy. Some patients, for one reason or another to make an informed decision about the side effects of chemotherapy are too serious and chooses not to receive this treatment.