Brigham and Women's Hospital

Located in the heart of Boston, Brigham and Women's Hospital has made its mark as a medical leader in a variety of types of cancer treatment, including asbestos-related cancers. The hospital is home to world-renowned physicians known for curative breakthroughs in mesothelioma.

Brigham and Women's is a teaching hospital of Harvard Medical School and known worldwide for excellence. The hospital is one of the few that has a program dedicated to asbestos cancer. The focus is placed on the most common type of asbestos cancer which is pleural mesothelioma. The hospital physicians, researchers and staff provide treatment for peritoneal mesothelioma, and other rare forms of cancer caused by asbestos.

International Mesothelioma Program (IMP)

About 2,500 patients are diagnosed with asbestos-related cancers every year. Up to 300 of them seek out Brigham and Women's International Mesothelioma Program for treatment or consultations. The hospital's program, which started in 2002, is the largest of its kind internationally and has hundreds on staff to assist. The IMP is multi-tiered, utilizing treatment, support and research programs to help patients and their families through treatment.

IMP goals

The program has specific goals and standards that it aims to meet and exceed. The IMP isn't just aimed at helping individual patients, but looking at mesothelioma as a whole and determining how to eradicate it. The goals of the program include the following:

• Develop the most-advanced therapies for mesothelioma.

Dr. David Sugarbaker

Famed thoracic surgeon Dr. David Sugarbaker started the IMP after he saw a marked increase in the number of asbestos cancer diagnoses. Sugarbaker, head of the hospital's thoracic surgery department, has dedicated his life to learning more about asbestos-related cancers. Many of the leaders in disease treatment and management have studied under Sugarbaker.

Diagnosing Asbestos Cancers

Sugarbaker believes that the best route to effective treatment is a clear-cut diagnosis. Researchers at the IMP are continually developing new tests to accommodate patients. The newest tests allow IMP physicians to adjust treatments to a patient's special needs.

• Extreme Drug Resistance - Also known as EDR, this determines whether a patient's tumors will likely be resistant to typical mesothelioma chemotherapy drugs. This allows doctors to adjust the chemotherapy accordingly.
• Gene Test - This newest gene test predicts if a patient will likely benefit from standard multimodal therapy, which includes chemotherapy, radiation and surgery, or if another type of treatment will work better.

Common Treatments Used at the IMP

From his decades of experience, Sugarbaker and his staff has developed individualized medical protocols for thousands of patients. Many years ago, Sugarbaker discovered that chemotherapy, radiation or surgery alone was not beneficial for asbestos-cancer patients. Instead, researchers found that a multimodal approach is optimum. However, some benefit from other types of treatments

• Intracavitary chemotherapy - Instead of taking the chemotherapy intravenously or orally, the liquid therapy is applied directly inside the chest or abdominal cavity. With this, doctors can utilize a much higher dose than if administered through the bloodstream. The drug enters the tumor cells directly without the normal toxic results of intravenous therapy. Sugarbaker has found that heating the chemotherapy agent may increase the killing effect.
• Biological response modifier (BRM) - Also known as immunotherapy, this uses the body's natural defenses to stop the spread of the cancer. This treatment allows the body to easier recognize asbestos-cancer cells and destroy them. Some BRMs are developed naturally in the body, but others are synthetically produced in a lab. Either way, the goal is to block the spread of cancer cells.
• Extrapleural pneumonectomy - This procedure removes the thin layer of tissue that surrounds the lungs and the diseased lung itself. In the past several years, this procedure has become controversial, with some doctors calling it extreme.