Dr. Marcelo DaSilva recalled a story about one of his first mesothelioma patients at AdventHealth in Orlando, Florida. This victim of mesothelioma, from Maryland, was rejected at one cancer center and received deflating news at another.

“This patient … they found me,” he said. “They looked me up, found me on Google, saw my background and where I worked. They drove down from Maryland.”

There have been others like this patient — people seeking hope from a new mesothelioma program in Central Florida — and there will be more in the future.

AdventHealth recently launched one of the country’s newest mesothelioma programs, the Mesothelioma International Treatment program (MITp). Dr. DaSilva leads the program, which is one of the few hospital-run mesothelioma initiatives in Florida.

Dr. Shanel Bhagwandin, a peritoneal mesothelioma specialist, works at Jupiter Medical Center. There’s also a program at Moffitt Cancer Center in Tampa. That’s about the extent.

In just six months, Dr. DaSilva and his team have already treated eight mesothelioma patients.

“To be able to build something that is beyond me, it’s a privilege,” Dr. DaSilva said. “It’s a great opportunity, and I feel honored.”

If you or your loved one has mesothelioma and is interested in seeing Dr. DaSilva, we can help you contact the AdventHealth staff. Connecting with him could lead to a valuable second opinion about your diagnosis and may reveal life-saving treatment options. Email our patient advocate and registered nurse, Karen Ritter, at karen@mesotheliomaguide.com to learn more.


How the MITp Started

Dr. DaSilva joined AdventHealth as the chief of thoracic surgery services in January 2020. He was hired due to his experience as a mesothelioma surgeon. Prior to starting the MITp, Dr. DaSilva worked at Brigham and Women’s Hospital in Boston, Massachusetts.

Brigham and Women’s Hospital is one of the finest in the country, and the mesothelioma program is regarded as one of the best in the world. Many esteemed mesothelioma specialists have worked there — and many still do.

Dr. DaSilva, though, took an opportunity to build a program from the ground up. He came to Central Florida to expand options for patients.

“Sharing my vision that we can do this to help people,” he said. “There are people who aren’t treated and are told there is nothing that can be done. My vision is that I don’t accept that.”

The first few months were awkward and unpredictable, notably due to the COVID-19 coronavirus pandemic. Seeing patients in the hospital was a challenge. The MITp staff resorted mostly to virtual meetings, or “telemedicine.” Dr. DaSilva considers it a blessing.

“COVID gave us pause to prepare,” he said.


AdventHealth Protocol for Mesothelioma Treatment

Five of the eight patients have already had surgery. Of them, four had pleural mesothelioma and one had peritoneal mesothelioma. Three more patients are preparing for surgery.

The protocol for mesothelioma treatment starts with four cycles of “neoadjuvant” chemotherapy, which is chemotherapy administered before surgery. A two- or three-week pause follows chemotherapy, and then the patient undergoes surgery.

For pleural mesothelioma patients, the operation is usually pleurectomy with decortication. This surgery spares both lungs and removes the pleura, which is the lining near the lungs, plus possibly the diaphragm and pericardium.

For peritoneal mesothelioma patients, the surgery used is cytoreduction. Dr. DaSilva and his staff treat both types of mesothelioma with heated intraoperative chemotherapy.

Pleural mesothelioma patients receive 60 minutes of this hot liquid chemotherapy delivered into their thorax. Peritoneal mesothelioma patients get 90 minutes of chemotherapy delivered into their abdomen.

Dr. DaSilva’s treatment focuses on epithelioid and biphasic cell types. Epithelioid mesothelioma has the best prognosis and is the most treatable. Sarcomatoid mesothelioma usually has the worst prognosis and is the toughest to treat.

Biphasic, which is a mixture of epithelioid and sarcomatoid cells, warrants differing opinions from specialists.

“I think biphasic, although it has a shorter survival than epithelioid, has a subset of patients who have a cancer closer to acting like epithelioid,” Dr. DaSilva said.


Building a Staff at AdventHealth

Dr. DaSilva has the exceptional quality of being a specialist for both types of mesothelioma. The MITp is seeing both pleural mesothelioma and peritoneal mesothelioma cases. He helped create the Brigham and Women’s Hospital peritoneal mesothelioma treatment protocol.

He has needed help from many to get AdventHealth’s program up and running so fast.

“Not at all. I’m totally surprised,” Dr. DaSilva said when asked if he expected to get eight patients in the first six months. “And I’m honored.”

The MITp staff includes a long list of medical professionals, up to 40 or 50 people, Dr. DaSilva said. He mentioned a few vital people but insisted that everyone deserves recognition. The mesothelioma treatment team at AdventHealth includes:

  • Medical oncologists Dr. Mark Socinski and Dr. Tarek Mekhail
  • Program navigator Dr. Brenda Rzeszutko
  • Radiation oncologist Dr. Rajesh Shah
  • Administrative assistant Dr. Deborah Huang
  • Anesthesiologist Dr. Alina Hulsey
  • Nurse practitioner Vanessa Cichon

There are around 3,000 new mesothelioma cases each year in the United States. According to the Centers for Disease Control and Prevention, there were 231 mesothelioma cases in Florida in 2016. Neighboring states Alabama and Georgia had a combined 99 cases.

With the new AdventHealth mesothelioma program, these patients have another option for state-of-the-art treatment.

    Sources & Author

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About the Writer, Devin Golden

Devin Golden is a content writer for Mesothelioma Guide. He produces mesothelioma-related content on various mediums, including the Mesothelioma Guide website and social media channels. Devin's objective is to translate complex information regarding mesothelioma into informative, easily absorbable content to help patients and their loved ones.