Helping patients with mesothelioma

Helping patients with mesothelioma

By Alexander Farivar, MD
Thoracic Surgeon

One of my passions is helping patients with malignant pleural mesothelioma (MPM). This is an aggressive cancer that is asbestos related, and affects the abdomen and/or chest. I specialize in chest mesothelioma. One of the reasons I trained in thoracic surgery, and mesothelioma surgery in specific, is that I believe passionately that there are treatment options for every single patient that can improve their quality of life, if not to give them a chance of cure and long term survival.

This optimism unfortunately is not a common belief among physicians. My experience in training in mesothelioma surgery at Brigham and Women’s Hospital in Boston, arguably the biggest international center treating mesothelioma, has shown me that people can survive for years after aggressive treatment including surgery. I know we can help patients with mesothelioma feel and breathe better, and enjoy their remaining years.

I’d like to present two of my patients to highlight this optimism. Unfortunately, since there are only 3000 new cases every year, physicians are often unaware of all the options. Most often recommend doing nothing or giving some chemotherapy without ever referring these patients to a center specializing in mesothelioma care, robbing them of the opportunity to feel better or have surgery with the goal of cure and long term survival.

“John” was 84 when I met him after he had been diagnosed with MPM in Forks. His physicians told him he had no options given his age, and recommended he get his affairs in order. He found us on the internet and showed up unannounced one Friday afternoon at 4 pm, begging for an evaluation and having trouble breathing. We admitted him after draining some fluid. He told us he already felt better and we obtained a chest CT confirming how much disease he had and helping us create a plan to intervene to improve his situation. We took him shortly thereafter to the operating room, obtained some tissue to prove his diagnosis, and placed a small, indwelling catheter in his pleural space so that he could drain the fluid himself whenever he felt short of breath. He was happy we helped him, and he drove himself home because he missed his dog. He wrote me a card one year later with a picture of his dog and himself fishing on a lake. He was still alive and happy. In his picture, he was smiling.

“Betsy” was 64 and was diagnosed with MPM. Her doctors said she could only get chemotherapy. She also found us on the internet and came up to see us from the Portland, Oregon area. We eventually went to the OR for an extrapleural pneumonectomy (EPP) after 2 cycles of chemotherapy. She did well and subsequently had a specialized form of radiation that we offer at Swedish for patients after EPP. She is still alive and doing well, and brought us the biggest box of chocolates I have ever seen the last time she came to see us in clinic. She was crying because she felt like she had been given another shot at life after she was told she essentially had no options.

Our thoracic group has recently published our results in operating on patients with MPM, demonstrating results as good as anywhere in the world We are proud to evaluate every patient with mesothelioma and help in any way possible.

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