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More About Mesothelioma Treatment at Tufts Medical Center
Dr. Martin Goodman joined the center after a fellowship at University of Pittsburgh Medical Center. He revolutionized the hospital’s treatment of peritoneal surface malignancies. This section of cancer includes peritoneal mesothelioma.
Dr. Goodman and his team see a handful of cases each year. It’s around the same amount leading to cytoreduction/HIPEC surgery. HIPEC is heated intraperitoneal chemotherapy, as doctors bathe the abdominal cavity in cancer-killing chemotherapy.
Tufts Medical Center is affiliated with Tufts University School of Medicine.
- Dr. Martin Goodman, Director of Peritoneal Surface Malignancies
- Dr. Lori Pai, medical oncologist
- Tufts University School of Medicine
- Cytoreductive/HIPEC surgery
- Systemic chemotherapy
Get Connected to Tufts Medical Center
Tufts Medical Center specializes in HIPEC surgery for peritoneal malignancies. Dr. Martin Goodman leads the peritoneal malignancy program, which includes peritoneal mesothelioma. This is one of the few centers able to treat peritoneal mesothelioma with aggressive surgery.
Why Choose Tufts Medical?
- HIPEC program with high case volume
- Option of using immunotherapy
Protocol for HIPEC/Cytoreduction Procedure
Dr. Goodman and his surgical team aim for an aggressive resection. Cytoreduction is called “debulking.” This process involves manually removing tumors from tissue and organs.
The team’s intent is to leave no tumors or microscopic cells in the abdominal cavity. Even with HIPEC washing the abdominal cavity, the best hope is to complete cytoreduction before the heated chemotherapy.
HIPEC surgery at this hospital takes 8‑14 hours, depending on the scope of disease. The omentum is taken out, plus any removable organs affected by tumors. These include the spleen, gallbladder and part of the colon. The drugs for HIPEC are cisplatin and doxorubicin.
“I think most of us who do this have a routine,” Dr. Goodman said, noting he starts cytoreductive surgery on the bottom right quadrant and moves counterclockwise around the cavity.
Patient selection often depends on metastasis to the small intestines. When there’s a specific level of tumor invasion on the small intestines, there’s a high rate of recurrence. Removing it will significantly reduce quality of life.
Recovery From HIPEC at Tufts Medical Center
Recovery from mesothelioma surgery is extensive. Tufts Medical Center prioritizes making sure patients are ready to move to each step. Inpatient recovery lasts 10‑12 days and outpatient recovery can take up to three months.
Dr. Goodman stresses the importance of being as active as possible during recovery. This combats blood clots and pneumonia, two complications patients sometimes experience.
Patients return to Tufts Medical Center for the first postoperative follow‑up appointment within two weeks of discharge. They’ll see an oncology dietician to create a nutrition plan and individualized patient care plan.
Follow‑up lab work is done every three months after surgery for the first two years, then every six months for years 3‑5 after surgery. CT scans are done every six months for the first two years and annually for years 3‑5.
- Not listed in the U.S. News & World Report 2023‑2024 Hospitals Honor Roll
- Ranked 5th in Massachusetts
- High performing for general cancer treatment
- High performing for gastrointestinal cancer surgery (peritoneal mesothelioma)
Other Therapies for Peritoneal Mesothelioma
If recurrence occurs quickly, patients are recommended to get systemic chemotherapy. This allows Dr. Goodman and the main medical oncologist, Dr. Lori Pai, to see if the tumors respond at all to the therapy. If so, a second HIPEC might work. If not, HIPEC might not be worthwhile.
If recurrence occurs years after the first HIPEC, then the recommendation is likely a second HIPEC as soon as possible.
Another option is immunotherapy. Opdivo and Yervoy were approved for malignant pleural mesothelioma. Another drug is Keytruda, which works the same as Opdivo. This is primarily an option for patients who can’t or don’t want to get HIPEC surgery.
Patients or families hoping to contact Dr. Goodman should reach out to our registered nurse. Karen Ritter can explain the process of contacting Tufts Medical Center or another cancer center. Email email@example.com or request recommendations on cancer centers here.
Sources & Author
- Martin D. Goodman, MD. Tufts Medical Center. Retrieved from: https://www.tuftsmedicalcenter.org/physiciandirectory/martin-goodman. Accessed: 10/06/2021.
- HIPEC Surgery – What to Expect. Tufts Medical Center. Retrieved from: https://www.tuftsmedicalcenter.org/patient-care-services/departments-and-services/cancer-center/clinical-care-services/peritoneal-surface-malignancy-program/what-to-expect-after-hipec-surgery. Accessed: 10/06/2021.
- Pai, Lori MD. Tufts Medical Center. Retrieved from: https://www.tuftsmedicalcenter.org/physiciandirectory/lori-pai. Accessed: 10/12/2021.
- Tufts Medical Center. U.S. News & World Report. Retrieved from: https://health.usnews.com/best-hospitals/area/ma/tufts-medical-center-6140465. Accessed: 10/19/2021.