With his partner, Paul Kelley has represented clients with mesothelioma due to asbestos exposure for nearly 30 years. In this podcast, he talks with John Maher about the prognosis for someone with mesothelioma and some of the treatment options.
John Maher: Hi, I’m John Maher, and I’m here today with Paul Kelley. Paul is a partner with the Kentucky personal injury law firm, Satterley & Kelley, which has over 30 years of collective experience in handling cases involving mesothelioma and asbestos exposure. Welcome, Paul.
Paul Kelley: Good morning, John. How are you?
John Maher: Good. So Paul, historically, what has been the prognosis for someone diagnosed with mesothelioma?
Paul: So historically, the prognosis has been six to 18 months from diagnosis to the passing of the patient.
Paul: That’s historically what it’s been, and we still certainly have clients that have passed within that time frame. The good news is with some improved treatments, we’ve seen people live 2, 3, 4 years, which is obviously a good thing, but historically, the data has been six to 18 months from date of diagnosis to death.
John: So there have been some people that have overcome that prognosis and lived longer? What are some of the outside lengths of time that somebody could survive it?
Paul: Oh, sure. I have a client myself who has lived for 13 years, post-diagnosis peritoneal mesothelioma. She is not an outlier. There are people reported in the medical and scientific literature that have lived for as long as 20 years with mesothelioma. The common component seems to be the type of mesothelioma. There’s several different types, but the two most common are pleural mesothelioma, which is in the chest, and peritoneal mesothelioma, which is in the abdomen.
People with peritoneal mesothelioma tend to have a slightly better prognosis, and they’re the ones that we typically see with this longer survival rate, going into the more than 10 years. It’s all uncommon, but certainly there are a considerable number of people that’ll live for more than 10 years with this disease. I think it’s a great testimony to both the advancements that have been made, with respect to this disease, over the last 15 years, as well as the will and fortitude of those particular patients who have done everything they can do in order to survive this terrible cancer.
John: What are some of the traditional treatment options for mesothelioma?
Paul: Chemotherapy is still the most likely treatment option. Of course, mesothelioma is cancer. Because of where it’s located, particularly the plural type, it can’t all necessarily be removed. Mesothelioma, while it’s associated with the lungs, it’s not really lung cancer. It affects the lining of the lung.
We have a plural lining that protects all of the organs from basically the ribs in each other. The pleura can’t be removed completely. It’s necessary. When pleural mesothelioma develops, oftentimes the only treatment is chemotherapy to try to reduce the tumor. If that shows some promise, then there’s some surgeries that can be done to treat it. We can talk about some of those surgeries.
John: Yeah, absolutely. In terms of talking about some of the more modern mesothelioma treatment options, why don’t you talk to us a little bit more about the surgeries and other options.
Paul: So probably 20 or 25 years ago, there was a famous surgeon in the United States. His name is David Sugarbaker. Dr. Sugarbaker unfortunately passed away a few years ago, but he developed a surgery for the mesothelioma, a couple different surgeries, and then other doctors have taken the mantle.
But those surgeries, there’s something called an extra pleural pneumonectomy. It is a significant surgery that’s not to be taken lightly. Obviously, there are some fantastic surgeons out there that can explain it better than I can, but basically what they do when they perform that surgery is they remove the affected lung.
Particularly if there’s just one lung that’s affected. They remove the lining around that lung. They remove parts of the diaphragm, and they remove the lymph nodes. It is a surgery, from my understanding, that takes hours to do, I mean, 6, 8, 10, 12 hours. Frequently, multiple surgeons will participate.
They have to cut through multiple ribs in order to do the surgery, but a successful extraoral pneumonectomy can result in significant life expansion for the patient. It’s invasive. It certainly is something that can put a patient out of commission for several weeks, but certainly it’s something that’s been proven to extend a patient’s life. Lots of them have been conducted. We’ve had a number of clients who have ultimately had that surgery, and many of them have had a pretty good overall outcome. Although it’s important to note John, that it’s not a cure. Frequently, it can have such a successful outcome that they may not detect cancer for a long time, but typically, they’ll not be able to get it all or it’ll come back. But, it certainly has been demonstrated to show a lot of benefit to a lot of different people.
A similar surgery that’s a little bit less invasive is something called pleurectomy and decortication. They remove parts of the pleura, and they remove tumors around the lung in the chest cavity area. It tends to be less invasive than the extrapleural pneumonectomy, although still a significant surgery, and still a surgery that would require the patient to be in the hospital for a number of weeks, and a rehab facility for a number of weeks. It would take some time to get back on their feet. But again, it’s been demonstrated to provide a very good outcome for patients, and to extend their life. In some instances, people have outlived their expectation by many years, like what we discussed earlier.
John: Yeah. So in terms of those treatment options and those surgeries, are one or both of those options actually removing one of their lungs, and then they’re just using one of the other lungs? Is that the case?
Paul: Yeah, I mean, if they remove one lung altogether, then the patient of course, will have just the one left. There are risks associated with that. I mean, the quality of life with one lung versus two is most certainly impacted, but I think most patients that have undergone it have said it beats the alternative, and they’ve been able to withstand some of the risks associated with having the surgery.
There are certainly risks that are associated with it, and it’s something not to be taken lightly. I think that anyone that makes a decision whether to do this surgery or not, has to consult with their doctors, their entire team. When people get this cancer, they’re not treated by one doctor. They have teams of doctors that consult with their family. It’s a very personal decision for everybody to make. There are certainly benefits and burdens associated with it, and some people decide that it’s not worth it, many people do.
From my standpoint as a lawyer, I have no opinion one way or the other as to what they ought to do, but from my standpoint as a person, as a friend to our client, is that we want them to do what they think is best for them, and we support them in any way they can. When you’re faced with the decision of whether you do this invasive surgery, where you could potentially pass away during the surgery, or you could have 12 weeks of rigorous rehabilitation, that’s a tough thing to do, particularly when there’s no guarantee that it will cure it, but certainly, possibility that’ll extend life and improve the quality of life eventually, which is what I think everybody’s goal is.
John: Right. Absolutely. What are some of the best doctors or hospitals available in the country for mesothelioma treatment?
Paul: There’s several. I’m here in Kentucky, and while I have great respect for all of the Kentucky hospitals and physicians, because of the rarity of mesothelioma, frequently, our clients will have to travel to other places where they have more experience and expertise in treating this cancer.
The Brigham and Women’s Hospital in Boston, Massachusetts, that’s where Dr. David Sugarbaker was for many years. They have a whole mesothelioma center there, which comes complete with some social work assistance. They have programs in place where people’s families can stay in a house for free while their loved one endures the surgery and the recovery from it. Brigham and Women’s Hospital is a place that we always tell people that you should talk to. The Lung Institute at Baylor College of Medicine, and MD Anderson, also in Houston, Texas, both of those hospitals are wonderful places with wonderful physicians.
Paul Sugarbaker, Dr. David Sugarbaker’s brother, he works in Texas and he has perfected the surgery on peritoneal mesothelioma. If someone has a peritoneal mesothelioma, I say go to Baylor and talk to that team of doctors. If they can’t help you, then I’m not sure that anybody can, but they’re excellent physicians. The University of Chicago Medicine Center has a wonderful program for mesothelioma. Mount Sinai in New York City also is a common place. The University of Pittsburgh Medical College in Pittsburgh also is a wonderful place that treats many mesothelioma patients and performs surgeries.
In terms of physicians, I mean, there’s many, and I hate to single anybody out. Certainly Dr. Paul Sugarbaker for peritoneal mesothelioma. I’ve not had the pleasure personally to meet him, but his reputation precedes him. If me or a loved one developed that cancer, that’s the first call I would make. In Brigham and Women’s, for pleural mesothelioma, Dr. Raphael Bueno, B-U-E-N-O, he kind of picked up the program after David Sugarbaker left Brigham and Women’s. He’s an excellent physician, treated a number of our patients, performed the extrapleural pneumonectomies and the pleurectomy and decortication. Excellent surgeons, Hedy Kindler, she used to be at University of Chicago. I think she’s moved on, but Dr. Kindler is an oncologist, and she has participated and organized the oncology treatment, chemotherapy administration, and associated treatment from an oncology standpoint.
There are many others, but those three physicians and two hospitals really stand out to but there’s certainly many others, New York City and Chicago, California, Pennsylvania, that specialize in these cancers. They get a lot of research money, and they’re just at the cutting edge, which you don’t see a lot of in middle America.
John: Right. All right. Well, that’s a really great list of resources for people affected by mesothelioma. Thanks again for your time, Paul.
Paul: No problem. Thank you.
John: For more information about mesothelioma and asbestos exposure, visit the law firm of Satterley & Kelley at satterleylaw.com or call 800-655-2117.