Mesothelioma News

David J. Sugarbaker, M.D.
Chief, Division of Thoracic Surgery

Medical Degree:

Cornell University Medical College 1979
Residencies:

Peter Bent Brigham Hospital-Intern in Surgery 1979-1980
Peter Bent Brigham Hospital-Junior Resident in Surgery 1980-1982
Brigham and Women’s Hospital-Senor Resident in Surgery 1984-1985
Toronto General Hospital, Mount Sinai Hospital, & Hospital For Sick Children, U. of Toronto-Chief Resident in Thoracic Surgery 1986-1987
Toronto General Hospital-Chief Resident in Cardiac Surgery 1987-1988
Hospital For Sick Children, U. of Toronto-Resident in Surgery 1987-1988
Fellowships:

Research Fellow in Gastroenterology, The Charles A. Dana Research Institute and the Harvard Thorndyke Laboratory, Beth Israel Hospital & Harvard Medical School – 1982-1984
Arthur Tracey Cabot Fellow in Surgery, Assistant to the Chief of Surgery, Chief Resident Surgeon, Brigham and Women’s Hospital – 1985-1986
Board Certifications:

Surgery 1987
Thoracic Surgery 1989
Academic Appointments:

Assistant Professor of Surgery, Harvard Medical School – 1988-1993
Associate Professor of Surgery, Harvard Medical School – 1993-1999
Richard E. Wilson Professor of Surgical Oncology, Harvard Medical School – 1999-
Biography

Dr. Sugarbaker is board certified in Thoracic Surgery and Surgery. He attended Wheaton College and Cornell University Medical School. He completed his Surgery residency at Brigham and Women’s Hospital and Cardiothoracic training at the Toronto General Hospital as Chief Resident in Thoracic Surgery and Chief Resident in Cardiac Surgery. His specific interests are in general thoracic surgery, minimally invasive surgery, lung volume reduction surgery, esophageal cancer, mesothelioma, non-small cell lung cancer, and video-assisted thoracic surgery(VATS).

Dr. Sugarbaker has been actively involved in the development of several programs. These include The Division of Thoracic Surgery 1988-present, the Brigham Lung Transplant Program, The Thoracic Oncology Program at the DFCI/BWH 1995-present, Surgical Services at the DFCI 1996-present, the Lung Volume Reduction Program at BWH 1996-present. In addition he has been active in the development of new minimally invasive surgical procedures and actively involved in the areas of therapy of thoracic malignancy.

Malignant pleural mesothelioma has been a central focus of Dr. Sugarbaker’s clinical and laboratory research. A trimodality therapeutic approach based on extrapleural pneumonectomy and adjuvant chemotherapy and radiation was developed and examined in a consecutive series of patients. Analysis of this series has revealed improved overall survival with acceptable morbidity and operative mortality, and has elucidated new prognostic variables in this disease. These include cell type, nodal status and resectablity, which have formed the foundation of a new staging system currently in use, which was presented to the American Surgical Association in 1996.

Laboratory investigation in mesothelioma has entailed the banking of frozen samples of more than 100 mesotheliomas that are currently the focus of research examining molecular markers in this disease. One important project seeks a definitive answer as to the potential role of Simian Virus 40 exposure (e.g. via contaminated polio vaccine) in mesothelioma through collaborative involvement with the NIH SV-40 working group.

As Chair of the Surgery Committee of the Cancer and Leukemia Group B (CALGB), it has been possible for Dr. Sugarbaker to play a leadership role in developing the clinical investigation of the role of surgery in cancer therapy trials, with the support of NCI U10 funding. This effort has supported the clinical investigation of new therapies in thoracic, GI and breast malignancies. These prospective clinical investigations have led to further NCI U10 support to examine the efficacy of new innovative minimally invasive thoracic surgery techniques in the staging and treatment of thoracic malignancy.

Concurrent laboratory work has focused on prognostic factors in stage I non-small cell lung cancer. Although surgery alone is standard therapy in this group of patients, 30-40% of them will succumb to recurrent disease. Identification of molecular and pathologic prognostic markers indicating metastatic potential in resected stage I tumors will facilitate selection of patients for adjuvant therapy. The evaluation of markers in our laboratory has led to the publication of a molecular substaging system for stage I non-small cell lung cancer. The prognostic significance of markers currently under study utilizes specimens from our respiratory tissue bank.

The establishment of the respiratory tissue bank in 1991 has led to the development of new methodologies for tissue processing and storage. This activity has led to extremely fruitful collaborative research projects. Prominent among these is “A gene expression approach to Adenocarcinoma classification”, a funded response to the NCI Director’s Challenge involving investigators at the Whitehead Institute, DFCI, MGH and BWH. Others have focused on the role of cell cycle regulatory pathways (Rb, cyclin D1, p16), matrix metalloproteinases (stromelysin-3), adhesion/motility proteins (paxillin, gelsolin), retinoid receptors and macrophage stimulating protein in the pathogenesis and metastasis of lung cancer. The bank has also supported large-scale gene discovery and expression profiling work in malignant pleural mesothelioma. “Evaluation of assays for detection of Simian Virus 40 DNA in Mesotheliomas”, a multicenter study by the International SV40 Working Group organized by the Viral Epidemiology Branch of the NCI, utilized specimens from the bank in a careful investigation of this sensitive public health issue.

Recently, the scope of the bank has been expanded. The BWH Tissue and Blood Repository now serves a broader role as an institutional core facility for specimen procurement and distribution in a wide array of malignancies as well as benign and neo-plastic tissues, blood, cells and nucleic acids. Dr. Sugarbaker serves as co-director and operations chair.

Dr Sugarbaker is Chief of Thoracic Surgery at Brigham and Women’s Hospital and the Richard E. Wilson Professor of Surgical Oncology at Harvard Medical School.

Source: http://www.chestsurg.org/about/staff/

Sugarbaker Oncology Associates
Specialty Section for the Treatment of Peritoneal Mesothelioma

Things are looking much improved for early detection…

Article Abstract: A 51-year-old man with no known history of asbestos exposure presented with hydropneumothorax. Soluble mesothelin-related protein testing and combined positron emission tomography and computed tomography were used to diagnose malignant pleural mesothelioma. One year after radical surgery and radiotherapy, there was no clinical recurrence.

O’Lone EL, Park EK, Sandrini A, Fogarty GB, Yates DH. St Vincent’s Hospital, Sydney, NSW, Australia.
Med J Aust. 2009 Feb 2;190(3):158-9

A recent news article pointed out how there’s a $176 million settlement in litigation for 300 survivors and relatives of those killed in a RI nightclub fire. Six years they’ve been waiting–as medical bills mount.

Sick workers employed by W.R. Grace & Co have been around since the mid 1990’s that peaked after 1999 news reported links between the vermiculite mine and the hundreds of sick and dying people exposed to asbestos. Plus over 800 Libby residents have filed wrongful death and personal injury cases against Grace.

Asbestos claims mount. Meanwhile, they’re still trying to figure out the extent of damage of low level exposure.

For thirty years, Newinski worked as a machinist for Northern States Power Co. In 2008, he won a $4.6 million judgment in an asbestos case againstJohn Crane Inc., which made products that Newinski used at work.

Newinski died at his home Tuesday Feb 10 at the age of 64.

The National Cancer Institute says asbestos is a known carcinogen that can increase the risk of lung cancer and mesothelioma, a relatively rare cancer of the thin membranes that line the chest and abdomen.

It can also increase the risk of asbestosis, a chronic lung condition that can cause shortness of breath, coughing and permanent lung damage.

Asbestos is a health hazard to construction workers who may be exposed to it on a regular basis, which is why the IEPA requires firms discovering asbestos to report it, halt demolition and hire a licensed asbestos removal firm.

Dr. Haining Yang as received a two-year, $100,000 grant from the Mesothelioma Applied Research Foundation as well as a two-year, $120,000 grant from the Hawai’i Community Foundation’s Leahi Fund. Dr Yang is Assistant Professor (Researcher), Cancer Research Center of Hawaii; John A. Burns School of Medicine Dr. Yang’s focus is “asbestos and mesothelioma pathogenesis. Malignant mesothelioma (MM) is a very aggressive tumor that causes approximately 2,500 deaths per year in the U.S. MM is incurable unless detected in its earlier stages. “