Brigham and Women’s Hospital and the International Mesothelioma Program now offer peritoneal mesothelioma surgery and treatment.
For several years, Dr. Marcelo DaSilva has been hoping to develop a mesothelioma program that would encompass both pleural and peritoneal treatments. When he returned to Brigham and Women’s Hospital (BWH) last year, Dr. DaSilva finally had the opportunity to create his dream program.
BWH is home to the International Mesothelioma Program (IMP), which many consider to be the best mesothelioma program in the country. Now they are also the only program to offer care for both peritoneal and pleural patients all in one program.
“We think that’s complementary with what we have been doing in the chest for years now with good results and good protocols and we’re very excited about it,” Dr. DaSilva told Mesothelioma Guide in a recent interview.
Filling a Gap in Mesothelioma Care
Dr. DaSilva hates turning patients away. He has specialized in treating pleural mesothelioma for years and is full of optimism for his patients. He chose to start treating peritoneal mesothelioma because about 30 percent of his pleural patients were returning to him with peritoneal mesothelioma. Up until recently, he had to send them away to other programs for treatment.
“If you send them out to another program, most of the people won’t [work with] them, ‘oh you already have meso in the chest, now you have it in the abdomen, forget about it’ but we see it different. We think if the patients could survive…we want to tackle that,” Dr. DaSilva said.
Dr. DaSilva believes there is hope for the patients who have both pleural and peritoneal mesothelioma. He would rather try to treat them himself instead of sending them home thinking, “there’s nothing for me” which could kill their spirit to fight the disease. He is especially hopeful because there are many other treatment options available if he is not able to perform surgery.
Dana-Farber Cancer Institute, another facility associated with BWH, is located across the street. For patients who aren’t eligible for surgery, they offer chemotherapy, immunotherapy, and targeted therapies.
BWH is also home to a very active research laboratory run by Dr. Raphael Bueno. They have performed important genetic research in the past and also offer clinical trials.
Creating the New Peritoneal Mesothelioma Program
For years the IMP has been performing pleural mesothelioma surgeries along with heated intraoperative chemotherapy (HIOC). The combination of surgery with heated chemotherapy directly on the affected area has helped them effectively treat many patients.
Peritoneal mesothelioma grows on the lining of the abdomen but the treatment plan is often very similar to pleural mesothelioma. Cytoreduction surgery is performed to remove tumors in the abdomen and then heated intraperitoneal chemotherapy (HIPEC) is used to kill any remaining cancer cells. Cytoreduction with HIPEC is the most effective treatment plan for most peritoneal mesothelioma patients.
Since the hospital staff has already had experience with mesothelioma and heated chemotherapy, the transition to treating peritoneal patients went fairly smoothly but still involved a lot of preparation. However, treating peritoneal patients differs significantly from treating pleural patients and the hospital needed to prepare.
In order to start the peritoneal program, new protocols needed to be written about medications, side effects, and which doctors and staff members would be involved. Also, the nurses in the intensive care unit (ICU) and on the floor needed to be trained on how to manage the new patients. Now, these protocols have been successfully implemented.
The new peritoneal program is a remarkable addition to what was already considered the most comprehensive mesothelioma program in the country. Dr. DaSilva and his team are enthusiastic about being able to treat more patients and not having to send away patients they have already gotten to know and care for.
“We’re very excited to be able to offer this to all our patients.”