The National Cancer Institute (NCI) has designated 40 cancer centers throughout the United States as "Comprehensive" centers. These elite centers have been recognized for their focus on scientific excellence and have dedicated themselves to the prevention, treatment and cure of cancer, including malignant mesothelioma. Following is a list of Cancer Centers by state.
For veterans wishing to be treated at a Veterans Health Administration (VA) cancer care facility, click here for a listing by state.
Alabama
UAB Comprehensive Cancer Center
1802 6th Avenue, S.
Birmingham, AL 35294
Request an appointment: (800) UAB-0933 or (205) 975-8222
Arizona
Arizona Cancer Center
1515 N. Campbell Avenue
Tucson, AZ 85724
Request an appointment: (520) 626-2900
California
City of Hope National Medical Center
1500 E. Duarte Road
Duarte, CA 91010
Request an appointment: (866) 434-HOPE (4673)
University of California, San Diego (UCSD) Moores Cancer Center
3855 Health Sciences Drive
La Jolla, CA 92093
Request an appointment: (866) 773-2703 or (858) 822-6200
UCLA Jonsson Comprehensive Cancer Center
10833 Le Conte Avenue
Los Angeles, CA 90095
Request an appointment: (800) 825-2631
USC/Norris Comprehensive Cancer Center
1441 Eastlake Avenue
Los Angeles, CA 90033
Request an appointment: (800) USC-CARE
University of California, Irvine (UCI) Chao Family Comprehensive Cancer Center
101 The City Drive, S.
Orange, CA 92868
Request an appointment: (877) UCI-DOCS (824-3627)
University of California, San Francisco (UCSF) Comprehensive Cancer Center
1600 Divisadero Street
San Francisco, CA 94115
Request an appointment: (888) 689-8273 or (415) 885-7777
Stanford University Comprehensive Cancer Center
875 Blake Wilbur Drive
Stanford, CA 94305
Request an appointment: (650) 498-6000
Colorado
University of Colorado Cancer Center
1665 N. Ursula Street
Aurora, CO 80045
Request an appointment: (800) 473-2288 or (720) 848-0300
Connecticut
Yale Cancer Center
15 York Street
New Haven, CT 06510
Request an appointment: (203) 785-4191
District of Columbia
Lombardi Comprehensive Cancer Center at Georgetown University
3800 Reservoir Road, NW
Washington, DC 20007
Request an appointment: (202) 444-2223
Florida
H. Lee Moffitt Cancer Center & Research Institute
12902 Magnolia Drive
Tampa, FL 33612
Request an appointment: (888) 860-2778 or (813) 979-3980
Illinois
Robert H. Lurie Comprehensive Cancer Center of Northwestern University
Galter Pavilion
675 N. St. Clair, 21st Floor
Chicago, IL 60611
Request an appointment: (866) LURIE-CC (587-4322)
Iowa
University of Iowa Holden Comprehensive Cancer Center
200 Hawkins Drive
Iowa City, IA 52242
Request an appointment: (319) 356-4200 8:00 am - 5:00 pm (M-F)
(800) 777-8442 or
(319) 384-8442 (After hours)
Maryland
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
401 N. Broadway
Baltimore, MD 21231
Request an appointment: (410) 955-5222
Massachusetts
Dana-Farber Cancer Institute
44 Binney Street
Boston, MA 02115
Request an appointment: (877) 332-4294
Michigan
University of Michigan Comprehensive Cancer Center
1500 E. Medical Center Drive
Ann Arbor, MI 48109
Request an appointment: (800) 865-1125
Barbara Ann Karmanos Cancer Institute
4100 John R
Detroit, MI 48201
Request an appointment: (800) KARMANOS (527-6266)
Minnesota
University of Minnesota Cancer Center
425 E. River Road
Minneapolis, MN 55455
Request an appointment: (888) CANCER MN (226-2376)
(Toll Free in IA, MN, ND, SD, WI)
(612) 624-2620 (Outside Area)
Mayo Clinic Cancer Center
200 First Street, SW
Rochester, MN 55905
Request an appointment: (507) 538-3270
Missouri
Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
660 S. Euclid Avenue
St. Louis, MO 63110
Request an appointment: (877) 251-6485 or (314) 747-3046
New Hampshire
Norris Cotton Cancer Center
One Medical Center Drive
Lebanon, NH 03756
Request an appointment: (603) 653-9000
New Jersey
Cancer Hospital of New Jersey at Robert Wood Johnson University Hospital
195 Little Albany Street
New Brunswick, NJ 08903
Request an appointment: (732) 828-3000
New York
Roswell Park Cancer Institute
Elm and Carlton Streets
Buffalo, NY 14263
Request an appointment: (800) ROSWELL (767-9355)
Memorial Sloan-Kettering Cancer Center
1275 York Avenue
New York, NY 10021
Request an appointment: (800) 525-2225
Herbert Irving Comprehensive Cancer Center
161 Fort Washington Avenue
New York, NY 10032
Request an appointment: (877) NYP-WELL (697-9355)
North Carolina
University of North Carolina (UNC) Lineberger Comprehensive Cancer Center
450 West Drive
Chapel Hill, NC 27599
Request an appointment: (866) 828-0270
Duke Comprehensive Cancer Center
2424 Erwin Road
Durham, NC 27705
Request an appointment: (888) ASK-DUKE (275-3853)
Wake Forest University Comprehensive Cancer Center
Medical Center Boulevard
Winston-Salem, NC 27157
Request an appointment: (800) 446-2255 or (336) 716-2255
Ohio
Case Comprehensive Cancer Center, Ireland Cancer Center
11100 Euclid Avenue
Cleveland, OH 44106
Request an appointment: (800) 641-2422
Comprehensive Cancer Center - Arthur G. James Cancer Hospital & Richard J. Solove Research Institute
300 W. 10th Avenue
Columbus, OH 43210
Request an appointment: (800) 293-5066 or (614) 293-5066
Pennsylvania
Abramson Cancer Center of the University of Pennsylvania
3400 Spruce Street
Philadelphia, PA 19104
Request an appointment: (800) 789-PENN (7366)
Fox Chase Cancer Center
333 Cottman Avenue
Philadelphia, PA 19111
Request an appointment: (215) 728-2570
University of Pittsburgh Cancer Institute
5150 Centre Avenue
Pittsburgh, PA 15232
Request an appointment: (412) 647-2811
Tennessee
Vanderbilt-Ingram Cancer Center
691 Preston Building
Nashville, TN 37232
Request an appointment: (800) 811-8480
Texas
University of Texas M. D. Anderson Cancer Center
1515 Holcombe Boulevard
Houston, TX 77030
Request an appointment: (800) 392-1611 or (713) 792-6161
Vermont
Vermont Cancer Center at the University of Vermont
89 Beaumont Avenue
Burlington, VT 05405
Request an appointment: (802) 656-4414
Washington
Fred Hutchinson Cancer Research Center
1100 Fairview Avenue, N.
Seattle, WA 98109
Request an appointment: (800) 804-8824 or (206) 288-1024
Wisconsin
University of Wisconsin Comprehensive Cancer Center
600 Highland Avenue
Madison, WI 53792
Request an appointment: (800) 622-8922
NATIONAL CANCER INSTITUTE CANCER CENTERS
UC Davis Cancer Center
4501 X Street
Sacramento, CA 95817
Request an appointment: (800) 362-5566 or (916) 734-5900
University of Chicago Hospitals
5841 S. Maryland Avenue
Chicago, IL 60637
Request an appointment: (888) UCH-0200
NYU Cancer Institute
550 First Avenue
New York, NY 10016
Request an appointment: (888) 7-NYU-MED (769-8633)
The Cleveland Clinic, Taussig Cancer Center
9500 Euclid Avenue
Cleveland, OH 44195
Request an appointment: (866) 320-4573 or (216) 444-5501
National Institutes of Health (NIH) Clinical Center, Bethesda, MD
National Insitutes of Health
10 Center Dr.
Bethesda, MD 20892
Request an appointment: 301-496-2626
Thoughts on choosing a cancer treatment.
Tuesday, November 3, 2009
FINDING A MESOTHELIOMA SPECIALIST
The following physicians are specialists in the treatment of malignant mesothelioma. You will find links to their web sites, when available and to some of their published articles.They are listed in no particular order with no particular endorsement.
Mesothelioma is typically treated by an interdisciplinary team of doctors rather than by a single physician. You may run into professionals called oncologists, thoracic surgeons, and pulmonologists. Glossary of members of a thoracic oncology care team. More on choosing your mesothelioma doctor.
W. Roy Smythe, MD
Professor and Chairman/Department of Surgery, Texas A&M University System Health Sciences Center, Scott & White Hospital, Temple, TX
Phone: 254-724-2595
Dr. Smythe is currently accruing patients for a protocol involving extrapleural pneumonectomy and Intensity Modulated Radiation Therapy (IMRT). (Click here for an abstract of this trial).
Biography
David C. Rice, M.B., B.Ch., B.A.O.; F.R.C.S.I
Associate Professor, Department of Thoracic and Cardiovascular Surgery, Division of Surgery/The University of Texas M. D. Anderson Cancer Center, Houston, TX
Phone: (713) 794-1477
Dr. Rice's main area of clinical interest lies in the surgical management of mesothelioma. In collaboration with colleagues in Radiation Oncology, he has furthered research into intensity modulated radiation therapy after surgical resection of mesothelioma. His research has lead to improved ways of preoperative staging of mesothelioma, and he has participated in neoadjuvant trials of chemotherapy and novel targeted agent.
Biography
David J. Sugarbaker, MD
Chief, Division of Thoracic Surgery/Brigham and Women's Hospital, Boston, MA Chief, Department of Surgical Services/Dana-Farber Cancer Institute, Boston, MA
Phone: (617) 732-6824
Dr. Sugarbaker believes in aggressive treatment of pleural mesothelioma. He is a proponent of tri-modal therapy; extrapleural pneumonectomy, chemotherapy and radiation.
Click here for an article by Dr. David J. Sugarbaker that appeared in the The Journal of Thoracic and Cardiovascular Surgery, January 1999 (12 pages in Adobe PDF format).
Biography
Lambros Zellos, MD, MPH
Attending Thoracic Surgeon; Clinical Co-Director of the International Mesothelioma Program/Brigham & Women's Hospital/Dana Farber Cancer Institute Harvard Medical School, Boston, MA
Phone: (617) 525-9657
Dr. Zellos is an Attending Thoracic Surgeon and the Clinical Co-Director of the International Mesothelioma Program. Dr. Zellos is a proponent of tailored multimodality therapy for each individual patient. Appropriate therapy may include surgery such as pleurectomy or extrapleural pneumonectomy with chemotherapy or radiation. Dr. Zellos has published several papers on multimodality therapy as well as methods to improve surgical techniques.
Valerie W. Rusch, FACS
Attending Thoracic Surgeon/Memorial-Sloan Kettering Cancer Center, New York, NY
Phone: (212) 639-5873
Dr. Rusch is known for the treatment of pleural mesothelioma. She has published several papers comparing pleural decortication to extrapleural pneumonectomy.
Biography
Raja M. Flores, MD
Attending Thoracic Surgeon/Memorial-Sloan Kettering Cancer Center, New York, NY
Phone: (212) 639-2806
Dr. Flores is currently the Principal Investigator on a clinical trial of neoadjuvant gemcitabine and cisplatin followed by extrapleural pneumonectomy and high dose radiation, as well as being involved in a trial of neoadjuvant Alimta/cisplatin, extrapleural pneumonectomy and high dose radiation. He has also compiled a 1,000 patient database to research areas of failure, and how to improve treatments for mesothelioma.
Biography
Paul H. Sugarbaker, MD, FACS, FRCS
Director, Surgical Oncology/Washington Cancer Institute, Washington, DC
Phone: (202) 877-3908
Dr. Sugarbaker is a specialist in the treatment of peritoneal mesothelioma using a combination of surgery, chemotherapy and radiation.
Brian W. Loggie, MD
Professor of Surgery, Creighton University Medical School; Chief, Division of Surgical Oncology; Director of Cancer Center/Creighton University Medical Center, Omaha, NE
Phone: (402) 280-4100
Dr. Loggie specializes in the treatment of peritoneal mesothelioma and peritoneal carcinomatosis. His protocol, based on eligibility, involves surgical debulking in combination with intraperitoneal heated chemotherapy.
Biography
David L. Bartlett, MD
Professor of Surgery, Chief, Division of Surgical Oncology/UPMC Cancer Pavilion, Pittsburgh, PA
Phone: (412) 692-2852
Dr. Bartlett has particular expertise in the management of advanced, complex abdominal malignancies. He also has a research interest in treating advanced carcinomas in the peritoneal cavity, including peritoneal mesothelioma.
Claire F. Verschraegen, MD
Director, Clinical Trial Office and Investigational Drug Program/Cancer Research and Treatment Center, University of New Mexico, Albuquerque, NM
Phone: (505) 272-4551
Dr. Verschraegen is currently conducting a front-line Alimta/gemcitabine trial for peritoneal mesothelioma patients. She also offers the following Phase I trials for patients who have already been treated with Alimta:
* Phase I Study of Capecitabine with Cisplatin and Irinotecan in Patients with Advanced Malignancies
* Phase I Study of Intravenous TZT-1027 and Gemcitabine, Administered on Day 1 and Day 8 of a Three Week Course in Patients with Advanced Solid Tumors
* Phase I Study of Flavoperidol in Combination with Gemcitabine and Irinotecan in Patients with Metastatic Cancer
Biography
David P. Mason, MD
Staff Surgeon, Department of Thoracic and Cardiovascular Surgery/Cleveland Clinic Foundation, Cleveland, OH
Phone: (216) 444-4053
Dr. Mason is a proponent of aggressive multimodality therapy for malignant mesothelioma. This includes extrapleural pneumonectomy, chemotherapy and radiation with Intensity Modulated Radiation Therapy (IMRT). Cleveland Clinic Foundation has a multidisciplinary Thoracic Oncology team with extensive experience and clinical trials in the management of malignant mesothelioma.
Biography
David M. Jablons, MD
Assistant Professor of Surgery Chief, General Thoracic Surgery/UCSF Mt. Zion Medical Center, San Francisco, CA
Phone: (415) 885-3882
Dr. Jablons treats pleural mesothelioma with a radical pleurectomy/decortication and is researching other therapies.
Biography
Lary A. Robinson, MD
Director, Division of Cardiovascular and Thoracic Surgery Principal Thoracic Surgical Oncologist/H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
Phone: (813) 972-8412
Dr. Robinson is a member of the multidisciplinary thoracic oncology group at H. Lee Moffitt Cancer Center which evaluates and treats all stages of mesothelioma. He is also involved in clinical research programs for lung cancer and mesothelioma.
Biography
Craig W. Stevens, MD, PhD
Division Chief, Radiation Oncology/H. Lee Moffitt Cancer Center & Research Institute/Tampa, FL
Phone: (813) 972-8424
Biography
Robert N. Taub, MD
Professor of Clinical Medicine, Columbia University College of Physicians and Surgeons/New York Presbyterian Hospital, New York, NY
Phone: (212) 305-4076
Dr. Robert Taub is a medical oncologist who directs the Connective Tissue Oncology Program at the Herbert Irving Comprehensive Cancer Center, where there are a number of ongoing multimodality studies of patients with pleural and peritoneal mesothelioma. The Center is based at the Columbia University College of Physicians and Surgeons. Click here for a press release announcing a new multimodality study.
Biography
Daniel Sterman, MD
Assistant Professor, Department of Medicine/University of Pennsylvania Medical Center, Philadelphia, PA
Phone: (215) 614-0984
Dr. Sterman is the co-author of several informative articles on treatment and clinical trials for pleural mesothelioma.
Biography
Eric Vallieres, MD
Associate Professor of Surgery, Section of General Thoracic Surgery/University of Washington Medical Center, Seattle, WA
Phone: (206) 598-4477
Dr. Vallieres uses a multidisciplinary approach to thoracic malignancies and related clinical trials. Please see Medical Journal & News Articles for an article Dr. Vallieres co-authored on Induction Chemotherapy, Extra Pleural Pneumonectomy And Adjuvant Fast Neutron Radiationtherapy For Pleural Mesothelioma (Dmm).
Biography
Stephen C. Yang, MD
Chief, Division of Thoracic Surgery/Associate Professor of Surgery and Oncology/Surgical Director, Lung Transplantation Program/Director, Thoracic Oncology Program/Johns Hopkins Medical Institutions, Baltimore, MD
Phone: (410) 614-3891
Biography
Mark J. Krasna, MD
Medical Director of the Cancer Institute at St. Joseph Medical Center/Towson, MD
Phone: (410) 427-2220
Dr. Krasna is the former Head of the Division of Thoracic Surgery, Professor of Surgery and Associate Director for Surgical Oncology in the Greenebaum Cancer Center at the University of Maryland Medical Center.
Dr. Krasna is a leader in the development of thoracic surgery. He is the author of the first textbook on thoracoscopic surgery and has instructed surgeons worldwide on his techniques.
Biography
David H. Harpole, Jr., MD
Associate Professor of Surgery, Thoracic Oncology Program/Assistant
Professor of Pathology, Duke University Medical Center, Durham, NC
Phone: (919) 668-8413
Biography
Harvey Pass, MD
Professor and Chief, Division of Thoracic Surgery and Thoracic Oncology, Department of Cardiothoracic Surgery/NYU School of Medicine and Comprehensive Cancer Center/New York, NY
Phone: (212) 263-7417
Gregory P. Kalemkerian, MD
Co-Director of Thoracic Oncology/University of Michigan Comprehensive Cancer Center/Ann Arbor, MI
Phone: (734) 936-5281
Dr. Kalemkerian directs the multidisciplinary thoracic oncology clinic at the University of Michigan Cancer Center, in addition to collaborating with the thoracic oncology team at Karmanos Cancer Institute, to develop novel clinical trials for mesothelioma patients.
Joseph S. Friedberg, MD
Chief of Thoracic Surgery/University of Pennsylvania at Presbyterian, Philadelphia, PA
Phone: (215) 662-9195
Dr. Friedberg is currently the Principal Investigator on a trial of photodynamic therapy for pleural malignancies, and also on a trial combining Alimta/cisplatin, surgery and XRT.
Robert Cameron, MD
UCLA Medical Center, Los Angeles, CA
Phone: (310) 794-7333
Mesothelioma is typically treated by an interdisciplinary team of doctors rather than by a single physician. You may run into professionals called oncologists, thoracic surgeons, and pulmonologists. Glossary of members of a thoracic oncology care team. More on choosing your mesothelioma doctor.
W. Roy Smythe, MD
Professor and Chairman/Department of Surgery, Texas A&M University System Health Sciences Center, Scott & White Hospital, Temple, TX
Phone: 254-724-2595
Dr. Smythe is currently accruing patients for a protocol involving extrapleural pneumonectomy and Intensity Modulated Radiation Therapy (IMRT). (Click here for an abstract of this trial).
Biography
David C. Rice, M.B., B.Ch., B.A.O.; F.R.C.S.I
Associate Professor, Department of Thoracic and Cardiovascular Surgery, Division of Surgery/The University of Texas M. D. Anderson Cancer Center, Houston, TX
Phone: (713) 794-1477
Dr. Rice's main area of clinical interest lies in the surgical management of mesothelioma. In collaboration with colleagues in Radiation Oncology, he has furthered research into intensity modulated radiation therapy after surgical resection of mesothelioma. His research has lead to improved ways of preoperative staging of mesothelioma, and he has participated in neoadjuvant trials of chemotherapy and novel targeted agent.
Biography
David J. Sugarbaker, MD
Chief, Division of Thoracic Surgery/Brigham and Women's Hospital, Boston, MA Chief, Department of Surgical Services/Dana-Farber Cancer Institute, Boston, MA
Phone: (617) 732-6824
Dr. Sugarbaker believes in aggressive treatment of pleural mesothelioma. He is a proponent of tri-modal therapy; extrapleural pneumonectomy, chemotherapy and radiation.
Click here for an article by Dr. David J. Sugarbaker that appeared in the The Journal of Thoracic and Cardiovascular Surgery, January 1999 (12 pages in Adobe PDF format).
Biography
Lambros Zellos, MD, MPH
Attending Thoracic Surgeon; Clinical Co-Director of the International Mesothelioma Program/Brigham & Women's Hospital/Dana Farber Cancer Institute Harvard Medical School, Boston, MA
Phone: (617) 525-9657
Dr. Zellos is an Attending Thoracic Surgeon and the Clinical Co-Director of the International Mesothelioma Program. Dr. Zellos is a proponent of tailored multimodality therapy for each individual patient. Appropriate therapy may include surgery such as pleurectomy or extrapleural pneumonectomy with chemotherapy or radiation. Dr. Zellos has published several papers on multimodality therapy as well as methods to improve surgical techniques.
Valerie W. Rusch, FACS
Attending Thoracic Surgeon/Memorial-Sloan Kettering Cancer Center, New York, NY
Phone: (212) 639-5873
Dr. Rusch is known for the treatment of pleural mesothelioma. She has published several papers comparing pleural decortication to extrapleural pneumonectomy.
Biography
Raja M. Flores, MD
Attending Thoracic Surgeon/Memorial-Sloan Kettering Cancer Center, New York, NY
Phone: (212) 639-2806
Dr. Flores is currently the Principal Investigator on a clinical trial of neoadjuvant gemcitabine and cisplatin followed by extrapleural pneumonectomy and high dose radiation, as well as being involved in a trial of neoadjuvant Alimta/cisplatin, extrapleural pneumonectomy and high dose radiation. He has also compiled a 1,000 patient database to research areas of failure, and how to improve treatments for mesothelioma.
Biography
Paul H. Sugarbaker, MD, FACS, FRCS
Director, Surgical Oncology/Washington Cancer Institute, Washington, DC
Phone: (202) 877-3908
Dr. Sugarbaker is a specialist in the treatment of peritoneal mesothelioma using a combination of surgery, chemotherapy and radiation.
Brian W. Loggie, MD
Professor of Surgery, Creighton University Medical School; Chief, Division of Surgical Oncology; Director of Cancer Center/Creighton University Medical Center, Omaha, NE
Phone: (402) 280-4100
Dr. Loggie specializes in the treatment of peritoneal mesothelioma and peritoneal carcinomatosis. His protocol, based on eligibility, involves surgical debulking in combination with intraperitoneal heated chemotherapy.
Biography
David L. Bartlett, MD
Professor of Surgery, Chief, Division of Surgical Oncology/UPMC Cancer Pavilion, Pittsburgh, PA
Phone: (412) 692-2852
Dr. Bartlett has particular expertise in the management of advanced, complex abdominal malignancies. He also has a research interest in treating advanced carcinomas in the peritoneal cavity, including peritoneal mesothelioma.
Claire F. Verschraegen, MD
Director, Clinical Trial Office and Investigational Drug Program/Cancer Research and Treatment Center, University of New Mexico, Albuquerque, NM
Phone: (505) 272-4551
Dr. Verschraegen is currently conducting a front-line Alimta/gemcitabine trial for peritoneal mesothelioma patients. She also offers the following Phase I trials for patients who have already been treated with Alimta:
* Phase I Study of Capecitabine with Cisplatin and Irinotecan in Patients with Advanced Malignancies
* Phase I Study of Intravenous TZT-1027 and Gemcitabine, Administered on Day 1 and Day 8 of a Three Week Course in Patients with Advanced Solid Tumors
* Phase I Study of Flavoperidol in Combination with Gemcitabine and Irinotecan in Patients with Metastatic Cancer
Biography
David P. Mason, MD
Staff Surgeon, Department of Thoracic and Cardiovascular Surgery/Cleveland Clinic Foundation, Cleveland, OH
Phone: (216) 444-4053
Dr. Mason is a proponent of aggressive multimodality therapy for malignant mesothelioma. This includes extrapleural pneumonectomy, chemotherapy and radiation with Intensity Modulated Radiation Therapy (IMRT). Cleveland Clinic Foundation has a multidisciplinary Thoracic Oncology team with extensive experience and clinical trials in the management of malignant mesothelioma.
Biography
David M. Jablons, MD
Assistant Professor of Surgery Chief, General Thoracic Surgery/UCSF Mt. Zion Medical Center, San Francisco, CA
Phone: (415) 885-3882
Dr. Jablons treats pleural mesothelioma with a radical pleurectomy/decortication and is researching other therapies.
Biography
Lary A. Robinson, MD
Director, Division of Cardiovascular and Thoracic Surgery Principal Thoracic Surgical Oncologist/H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
Phone: (813) 972-8412
Dr. Robinson is a member of the multidisciplinary thoracic oncology group at H. Lee Moffitt Cancer Center which evaluates and treats all stages of mesothelioma. He is also involved in clinical research programs for lung cancer and mesothelioma.
Biography
Craig W. Stevens, MD, PhD
Division Chief, Radiation Oncology/H. Lee Moffitt Cancer Center & Research Institute/Tampa, FL
Phone: (813) 972-8424
Biography
Robert N. Taub, MD
Professor of Clinical Medicine, Columbia University College of Physicians and Surgeons/New York Presbyterian Hospital, New York, NY
Phone: (212) 305-4076
Dr. Robert Taub is a medical oncologist who directs the Connective Tissue Oncology Program at the Herbert Irving Comprehensive Cancer Center, where there are a number of ongoing multimodality studies of patients with pleural and peritoneal mesothelioma. The Center is based at the Columbia University College of Physicians and Surgeons. Click here for a press release announcing a new multimodality study.
Biography
Daniel Sterman, MD
Assistant Professor, Department of Medicine/University of Pennsylvania Medical Center, Philadelphia, PA
Phone: (215) 614-0984
Dr. Sterman is the co-author of several informative articles on treatment and clinical trials for pleural mesothelioma.
Biography
Eric Vallieres, MD
Associate Professor of Surgery, Section of General Thoracic Surgery/University of Washington Medical Center, Seattle, WA
Phone: (206) 598-4477
Dr. Vallieres uses a multidisciplinary approach to thoracic malignancies and related clinical trials. Please see Medical Journal & News Articles for an article Dr. Vallieres co-authored on Induction Chemotherapy, Extra Pleural Pneumonectomy And Adjuvant Fast Neutron Radiationtherapy For Pleural Mesothelioma (Dmm).
Biography
Stephen C. Yang, MD
Chief, Division of Thoracic Surgery/Associate Professor of Surgery and Oncology/Surgical Director, Lung Transplantation Program/Director, Thoracic Oncology Program/Johns Hopkins Medical Institutions, Baltimore, MD
Phone: (410) 614-3891
Biography
Mark J. Krasna, MD
Medical Director of the Cancer Institute at St. Joseph Medical Center/Towson, MD
Phone: (410) 427-2220
Dr. Krasna is the former Head of the Division of Thoracic Surgery, Professor of Surgery and Associate Director for Surgical Oncology in the Greenebaum Cancer Center at the University of Maryland Medical Center.
Dr. Krasna is a leader in the development of thoracic surgery. He is the author of the first textbook on thoracoscopic surgery and has instructed surgeons worldwide on his techniques.
Biography
David H. Harpole, Jr., MD
Associate Professor of Surgery, Thoracic Oncology Program/Assistant
Professor of Pathology, Duke University Medical Center, Durham, NC
Phone: (919) 668-8413
Biography
Harvey Pass, MD
Professor and Chief, Division of Thoracic Surgery and Thoracic Oncology, Department of Cardiothoracic Surgery/NYU School of Medicine and Comprehensive Cancer Center/New York, NY
Phone: (212) 263-7417
Gregory P. Kalemkerian, MD
Co-Director of Thoracic Oncology/University of Michigan Comprehensive Cancer Center/Ann Arbor, MI
Phone: (734) 936-5281
Dr. Kalemkerian directs the multidisciplinary thoracic oncology clinic at the University of Michigan Cancer Center, in addition to collaborating with the thoracic oncology team at Karmanos Cancer Institute, to develop novel clinical trials for mesothelioma patients.
Joseph S. Friedberg, MD
Chief of Thoracic Surgery/University of Pennsylvania at Presbyterian, Philadelphia, PA
Phone: (215) 662-9195
Dr. Friedberg is currently the Principal Investigator on a trial of photodynamic therapy for pleural malignancies, and also on a trial combining Alimta/cisplatin, surgery and XRT.
Robert Cameron, MD
UCLA Medical Center, Los Angeles, CA
Phone: (310) 794-7333
MESOTHELIOMA DIAGNOSIS
How is mesothelioma diagnosed?
A diagnosis of mesothelioma is most often obtained with careful assessment of clinical and radiological findings in addition to a confirming tissue biopsy. (Learn about typical mesothelioma symptoms.) A review of the patient's medical history, including history of asbestos exposure is taken, followed by a complete physical examination, x-rays of the chest or abdomen, and lung function tests. A CT scan or MRI may also be done at this time. If any of these preliminary tests prove suspicious for mesothelioma; a biopsy is necessary to confirm this diagnosis.
Imaging Techniques and Their Value in Diagnosing and Assessing Mesothelioma
There are several imaging techniques which may prove useful when mesothelioma is suspected due to the presence of pleural effusion combined with a history of occupational or secondary asbestos exposure. While these imaging techniques can be valuable in assessing the possibility of the cancer, definitive diagnosis is still most often established through fluid diagnosis or tissue biopsy.
Some of the most commonly used imaging methods include:
• X-ray
A chest x-ray can reveal pleural effusion (fluid build-up) which is confined to either the right (60%) or left (40%) lung. On occasion, a mass may be seen. Signs of prior non-cancerous asbestos disease, such as pleural plaques or pleural calcification, or scarring due to asbestosis may also be noted.
• Computed Tomography (CT)
CT scans are also able to define pleural effusion, as well as pleural thickening, pleural calcification, thickening of interlobular fissures, or possible chest wall invasion. CT, however, is not able to differentiate between changes associated with benign asbestos disease (pleural disease), or differentiate between adenocarcinoma of the lung wh
ich may have spread to the pleura verses mesothelioma. CT scans may also be valuable in guiding fine needle aspiration of pleural masses for tissue diagnosis.
• Magnetic Resonance Imaging (MRI)
MRI scans are most often used to determine the extent of tumor prior to aggressive treatment. Because they provide images in multiple planes, they are better able to identify tumors as opposed to normal structures. They are also more accurate than CT scans in assessing enlargement of the mediastinal lymph nodes (those lymph nodes which lie between the two lungs), as well as a clear diaphragmatic surface, both of which play an important role in surgical candidacy.
• Positron Emission Tomography (PET)
PET imaging is now becoming an important part of the diagnosis and evaluation of mesothelioma. While PET scans are more expensive than other types of imaging, and are not always covered under insurance, they are now considered to be the most diagnostic of tumor sites, as well as the most superior in determining the staging of mesothelioma. Further explanation of PET scans.
• CT/PET
For patients who may be candidates for aggressive multimodality treatment (surgery, chemotherapy and radiation), accurate clinical staging is extremely important. Integrated CT/PET imaging provides a relatively new tool in this respect, and has become the imaging technique of choice for determining surgical eligibility. By combining the benefits of CT and PET (anatomic and metabolic information) into a single scan, this technology can more accurately determine the stage of the cancer, and can help identify the best treatment option for the patient. Read about a study of CT-PET imaging in preoperative evaluation of patients with malignant pleural mesothelioma.
A needle biopsy of the mass, or the removal and examination of the fluid surrounding the lung, may be used for diagnosis, however, because these samples are sometimes inadequate as far as determining cell type (epithelial, sarcomatous, or mixed) or because of the unreliability of fluid diagnosis, open pleural biopsy may be recommended. In a pleural biopsy procedure, a surgeon will make a small incision through the chest wall and insert a thin, lighted tube called a thoracoscope into the chest between two ribs. He will then remove a sample of tissue to be reviewed under a microscope by a pathologist. In a peritoneal biopsy, the doctor makes a small incision in the abdomen and inserts a peritoneoscope into the abdominal cavity.
Once mesothelioma is suspected through imaging tests, it is confirmed by pathological examination. Tissue is removed, put under the microscope, and a pathologist makes a definitive diagnosis, and issues a pathology report. This is the end of a process that usually begins with symptoms that send most people to the doctor: a fluid build-up or pleural effusions, shortness of breath, pain in the chest, or pain or swelling in the abdomen. The doctor may order an x-ray or CT scan of the chest or abdomen. If further examination is warranted, the following tests may be done:
* Video-Assisted Thoracoscopic Surgery (VATS)
Over the past decade, the use of video-assisted thoracic surgery (VATS) has become one of the most widely used tools in the diagnosis of mesothelioma. Biopsies of the pleural lining, nodules, masses and pleural fluid can now easily be obtained using this minimally invasive procedure, and other therapies such as pleurodesis (talc) for pleural effusions can be done concurrently.While the patient is under general anesthesia, several small incisions or “ports” are made through the chest wall. The surgeon then inserts a small camera, via a scope, into one incision, and other surgical instruments used to retrieve tissue samples into the other incisions. By looking at a video screen showing the camera images, the surgeon is able to complete whatever procedures are necessary
In many cases, this video-assisted technique is able to replace thoracotomy, which requires a much larger incision to gain access to the chest cavity, and because it is minimally invasive, the patient most often has less post-operative pain and a potentially shorter recovery period.
* Thoracoscopy
For pleural mesothelioma the doctor may look inside the chest cavity with a special instrument called a thoracoscope. A cut will be made through the chest wall and the thoracoscope will be put into the chest between two ribs. This test is usually done in a hospital with a local anesthetic or painkiller.
If fluid has collected in your chest, your doctor may drain the fluid out of your body by putting a needle into your chest and use gentle suction to remove the fluid. This is called thoracentesis.
* Peritoneoscopy
For peritoneal mesothelioma the doctor may also look inside the abdomen with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is usually done in the hospital under a local anesthetic.
If fluid has collected in your abdomen, your doctor may drain the fluid out of your body by putting a needle into your abdomen and using gentle suction to remove the fluid. This process is called paracentesis.
* Biopsy
If abnormal tissue is found, the doctor will need to cut out a small piece and have it looked at under a microscope. This is usually done during the thoracoscopy or peritoneoscopy, but can be done during surgery. More on needle biopsies.
Pathology and The Role of Pathologists in the Diagnostic Process
Pathology, or the scientific study of cells, tissue, or fluid taken from the body is an integral part of a mesothelioma diagnosis. Most hospitals have their own pathology labs staffed by board-certified pathologists and licensed technologists. The importance of pathological diagnosis can not be underestimated, since the course of treatment is dependent upon an accurate diagnosis.
To make a diagnosis, pathologists examine tissue under a microscope, and based on established criteria, make a determination of benign vs. malignant cells. (More on biopsy tissue processing.) Subsequently, the type of cancer is determined. Although most pathologists have a general expertise of various diseases, a small number acquire training in a subspecialty, such as mesothelioma. These are physicians who have received world-wide recognition as premier experts, and have achieved high acclaim for their research, published articles and abstracts, and teaching. For a list of expert pathologists in the field of mesothelioma diagnosis, please call the MW toll free at 1-877-367-6376 or fill in the form at the bottom of this page specifying your request.
Knowing the stage is a factor in helping the doctor form a treatment plan. Mesothelioma is considered localized if the cancer is confined to the pleura, or advanced if it has spread beyond the pleura to other parts of the body such as the lungs, chest wall, abdominal cavity, or lymph nodes.
Immunohistochemical Markers for Mesothelioma
A diagnosis of any specific type of cancer often means ruling out other cancers in the process. This is true in the case of mesothelioma, where the most common “differential diagnosis” is that of adenocarcinoma versus mesothelioma.
During the biopsy procedure, the surgeon removes tissue samples to be sent to the laboratory. In the lab, slides are produced and then viewed and analyzed by a pathologist. These tissue specimens arrive at the lab with a request form that details patient information and history along with a description of the site in the body from which the specimen was obtained. Each individual specimen is numbered for each patient.
The pathologist then does a “gross examination” which consists of describing the tissue, and then placing it in a plastic cassette. The cassettes are then placed in a fixative that preserves the tissue permanently. Once the tissue has been fixed, it is processed into a paraffin block that will allow the pathologist to slice off thin microscopic sections that will then be stained to determine the patient’s diagnosis.
Immunohistochemistry is defined as “a method of analyzing and identifying cell types based on the binding of antibodies to specific components of the cell”. It is this process that helps diagnose mesothelioma versus adenocarcinoma (or other types of cancer).
Early on, the “markers” which helped distinguish mesothelioma from adenocarcinoma were “negative markers”; those expressed in adenocarcinomas, but not in mesotheliomas. This made it more difficult to confirm a diagnosis, because pathologists were dealing with the absence of, rather than the presence of certain markers. Some of these markers, which are normally “positive” in an adenocarcinoma diagnosis and “negative” in a mesothelioma diagnosis, are carcinoembryonic antigen (CEA), CD 15 (LeuM1), epithelial glycoprotein (Bg8), tumor glycoprotein (BerEp4) and tumor glycoprotein (MOC-31).
In more recent years, “positive markers” expressed by mesotheliomas have come to the forefront. Some of the markers which are normally “positive” in mesotheliomas and “negative” in adenocarcincomas are calretinin, cytokeratin 5, HBME-1, mesothelin, N-cadherin, thrombomodulin, vimentin and Wilm’s tumor gene product (WT-1).
It is important to remember that while the above markers are commonly used to help diagnose the epithelial sub-type of mesothelioma, that they may also be expressed in other types of cancer, and may not necessarily apply to the bi-phasic or sarcomatoid sub-types of mesothelioma. Your doctor can always contact a more specialized lab if he/she feels your diagnosis is in any way inconclusive.
A diagnosis of mesothelioma is most often obtained with careful assessment of clinical and radiological findings in addition to a confirming tissue biopsy. (Learn about typical mesothelioma symptoms.) A review of the patient's medical history, including history of asbestos exposure is taken, followed by a complete physical examination, x-rays of the chest or abdomen, and lung function tests. A CT scan or MRI may also be done at this time. If any of these preliminary tests prove suspicious for mesothelioma; a biopsy is necessary to confirm this diagnosis.
Imaging Techniques and Their Value in Diagnosing and Assessing Mesothelioma
There are several imaging techniques which may prove useful when mesothelioma is suspected due to the presence of pleural effusion combined with a history of occupational or secondary asbestos exposure. While these imaging techniques can be valuable in assessing the possibility of the cancer, definitive diagnosis is still most often established through fluid diagnosis or tissue biopsy.
Some of the most commonly used imaging methods include:
• X-ray
A chest x-ray can reveal pleural effusion (fluid build-up) which is confined to either the right (60%) or left (40%) lung. On occasion, a mass may be seen. Signs of prior non-cancerous asbestos disease, such as pleural plaques or pleural calcification, or scarring due to asbestosis may also be noted.
• Computed Tomography (CT)
CT scans are also able to define pleural effusion, as well as pleural thickening, pleural calcification, thickening of interlobular fissures, or possible chest wall invasion. CT, however, is not able to differentiate between changes associated with benign asbestos disease (pleural disease), or differentiate between adenocarcinoma of the lung wh
ich may have spread to the pleura verses mesothelioma. CT scans may also be valuable in guiding fine needle aspiration of pleural masses for tissue diagnosis.
• Magnetic Resonance Imaging (MRI)
MRI scans are most often used to determine the extent of tumor prior to aggressive treatment. Because they provide images in multiple planes, they are better able to identify tumors as opposed to normal structures. They are also more accurate than CT scans in assessing enlargement of the mediastinal lymph nodes (those lymph nodes which lie between the two lungs), as well as a clear diaphragmatic surface, both of which play an important role in surgical candidacy.
• Positron Emission Tomography (PET)
PET imaging is now becoming an important part of the diagnosis and evaluation of mesothelioma. While PET scans are more expensive than other types of imaging, and are not always covered under insurance, they are now considered to be the most diagnostic of tumor sites, as well as the most superior in determining the staging of mesothelioma. Further explanation of PET scans.
• CT/PET
For patients who may be candidates for aggressive multimodality treatment (surgery, chemotherapy and radiation), accurate clinical staging is extremely important. Integrated CT/PET imaging provides a relatively new tool in this respect, and has become the imaging technique of choice for determining surgical eligibility. By combining the benefits of CT and PET (anatomic and metabolic information) into a single scan, this technology can more accurately determine the stage of the cancer, and can help identify the best treatment option for the patient. Read about a study of CT-PET imaging in preoperative evaluation of patients with malignant pleural mesothelioma.
A needle biopsy of the mass, or the removal and examination of the fluid surrounding the lung, may be used for diagnosis, however, because these samples are sometimes inadequate as far as determining cell type (epithelial, sarcomatous, or mixed) or because of the unreliability of fluid diagnosis, open pleural biopsy may be recommended. In a pleural biopsy procedure, a surgeon will make a small incision through the chest wall and insert a thin, lighted tube called a thoracoscope into the chest between two ribs. He will then remove a sample of tissue to be reviewed under a microscope by a pathologist. In a peritoneal biopsy, the doctor makes a small incision in the abdomen and inserts a peritoneoscope into the abdominal cavity.
Once mesothelioma is suspected through imaging tests, it is confirmed by pathological examination. Tissue is removed, put under the microscope, and a pathologist makes a definitive diagnosis, and issues a pathology report. This is the end of a process that usually begins with symptoms that send most people to the doctor: a fluid build-up or pleural effusions, shortness of breath, pain in the chest, or pain or swelling in the abdomen. The doctor may order an x-ray or CT scan of the chest or abdomen. If further examination is warranted, the following tests may be done:
* Video-Assisted Thoracoscopic Surgery (VATS)
Over the past decade, the use of video-assisted thoracic surgery (VATS) has become one of the most widely used tools in the diagnosis of mesothelioma. Biopsies of the pleural lining, nodules, masses and pleural fluid can now easily be obtained using this minimally invasive procedure, and other therapies such as pleurodesis (talc) for pleural effusions can be done concurrently.While the patient is under general anesthesia, several small incisions or “ports” are made through the chest wall. The surgeon then inserts a small camera, via a scope, into one incision, and other surgical instruments used to retrieve tissue samples into the other incisions. By looking at a video screen showing the camera images, the surgeon is able to complete whatever procedures are necessary
In many cases, this video-assisted technique is able to replace thoracotomy, which requires a much larger incision to gain access to the chest cavity, and because it is minimally invasive, the patient most often has less post-operative pain and a potentially shorter recovery period.
* Thoracoscopy
For pleural mesothelioma the doctor may look inside the chest cavity with a special instrument called a thoracoscope. A cut will be made through the chest wall and the thoracoscope will be put into the chest between two ribs. This test is usually done in a hospital with a local anesthetic or painkiller.
If fluid has collected in your chest, your doctor may drain the fluid out of your body by putting a needle into your chest and use gentle suction to remove the fluid. This is called thoracentesis.
* Peritoneoscopy
For peritoneal mesothelioma the doctor may also look inside the abdomen with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is usually done in the hospital under a local anesthetic.
If fluid has collected in your abdomen, your doctor may drain the fluid out of your body by putting a needle into your abdomen and using gentle suction to remove the fluid. This process is called paracentesis.
* Biopsy
If abnormal tissue is found, the doctor will need to cut out a small piece and have it looked at under a microscope. This is usually done during the thoracoscopy or peritoneoscopy, but can be done during surgery. More on needle biopsies.
Pathology and The Role of Pathologists in the Diagnostic Process
Pathology, or the scientific study of cells, tissue, or fluid taken from the body is an integral part of a mesothelioma diagnosis. Most hospitals have their own pathology labs staffed by board-certified pathologists and licensed technologists. The importance of pathological diagnosis can not be underestimated, since the course of treatment is dependent upon an accurate diagnosis.
To make a diagnosis, pathologists examine tissue under a microscope, and based on established criteria, make a determination of benign vs. malignant cells. (More on biopsy tissue processing.) Subsequently, the type of cancer is determined. Although most pathologists have a general expertise of various diseases, a small number acquire training in a subspecialty, such as mesothelioma. These are physicians who have received world-wide recognition as premier experts, and have achieved high acclaim for their research, published articles and abstracts, and teaching. For a list of expert pathologists in the field of mesothelioma diagnosis, please call the MW toll free at 1-877-367-6376 or fill in the form at the bottom of this page specifying your request.
Knowing the stage is a factor in helping the doctor form a treatment plan. Mesothelioma is considered localized if the cancer is confined to the pleura, or advanced if it has spread beyond the pleura to other parts of the body such as the lungs, chest wall, abdominal cavity, or lymph nodes.
Immunohistochemical Markers for Mesothelioma
A diagnosis of any specific type of cancer often means ruling out other cancers in the process. This is true in the case of mesothelioma, where the most common “differential diagnosis” is that of adenocarcinoma versus mesothelioma.
During the biopsy procedure, the surgeon removes tissue samples to be sent to the laboratory. In the lab, slides are produced and then viewed and analyzed by a pathologist. These tissue specimens arrive at the lab with a request form that details patient information and history along with a description of the site in the body from which the specimen was obtained. Each individual specimen is numbered for each patient.
The pathologist then does a “gross examination” which consists of describing the tissue, and then placing it in a plastic cassette. The cassettes are then placed in a fixative that preserves the tissue permanently. Once the tissue has been fixed, it is processed into a paraffin block that will allow the pathologist to slice off thin microscopic sections that will then be stained to determine the patient’s diagnosis.
Immunohistochemistry is defined as “a method of analyzing and identifying cell types based on the binding of antibodies to specific components of the cell”. It is this process that helps diagnose mesothelioma versus adenocarcinoma (or other types of cancer).
Early on, the “markers” which helped distinguish mesothelioma from adenocarcinoma were “negative markers”; those expressed in adenocarcinomas, but not in mesotheliomas. This made it more difficult to confirm a diagnosis, because pathologists were dealing with the absence of, rather than the presence of certain markers. Some of these markers, which are normally “positive” in an adenocarcinoma diagnosis and “negative” in a mesothelioma diagnosis, are carcinoembryonic antigen (CEA), CD 15 (LeuM1), epithelial glycoprotein (Bg8), tumor glycoprotein (BerEp4) and tumor glycoprotein (MOC-31).
In more recent years, “positive markers” expressed by mesotheliomas have come to the forefront. Some of the markers which are normally “positive” in mesotheliomas and “negative” in adenocarcincomas are calretinin, cytokeratin 5, HBME-1, mesothelin, N-cadherin, thrombomodulin, vimentin and Wilm’s tumor gene product (WT-1).
It is important to remember that while the above markers are commonly used to help diagnose the epithelial sub-type of mesothelioma, that they may also be expressed in other types of cancer, and may not necessarily apply to the bi-phasic or sarcomatoid sub-types of mesothelioma. Your doctor can always contact a more specialized lab if he/she feels your diagnosis is in any way inconclusive.
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