Why did you choose to focus on pleural mesothelioma?

 

I like challenges. My younger brother used to say “when you want Loїc to do something, just tell him it is impossible to do!”. I went into mesothelioma research and treatment because it was a difficult disease and because we had no solutions. When I started my postgraduate training in Cardiothoracic Surgery back in 1991, pleural mesothelioma was a death sentence and there was global nihilism. Only few people had an interest in the disease and dared try new therapeutic options. I was lucky to meet Dr David Sugarbaker, Chief of Thoracic Surgery at the Brigham and Women Hospital in Boston and Professor of Thoracic surgery at Harvard Medical School, at a surgical meeting in Paris, France. He had developed a trimodality approach to mesothelioma in Boston and presented encouraging results. I was really impressed by the man and by the surgeon, as he was really trying hard to find a cure for mesothelioma. I visited him several times at the Brigham and Women Hospital between 1998 and 2012 and learned a great deal from him and his colleagues. He was -and still is-an inspiration for me and for many other surgeons in my generation. One thing I shall never forget is the answer he would invariably give patients when they asked “how long do I have Doc?”: He would reply calmly “you know, when hope is part of the equation, everything is possible!”. I always quote him when my patients ask the same question. I believe that our first duty as doctors is to offer comfort and hope, then try to find the best option for a specific patient.

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Is mesothelioma curable now?

 

Thanks to medical research and new technology developments in the past 30 years, more cancers can now be cured or palliated effectively over several years. Mesothelioma remains incurable, but life can be extended significantly for many patients who are fit and willing to receive treatment. Patients can be cancer-free for some time, and then restart treatment when the tumor relapses. I follow up many patients I operated on years ago and who are still enjoying a good quality of life despite being diagnosed with mesothelioma 5, 10 or sometimes 15 years ago. Some have received more than 6 or 7 different kinds of therapies, but they still live well.

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Is there international collaboration in the field of mesothelioma?

 

The International Mesothelioma Interest Group -founded in 1991- has flourished and organises an international meeting attracting hundreds of physicians, surgeons, nurses and scientists every other year. Many other scientific organizations (ESTS, EACTS, ERS, IASLC, ESMO, ASCO, EORTC, ETOP) have formed task forces or expert groups and dozens of clinical trials involving new drugs or therapies have been offered to patients suffering from pleural mesothelioma in the past 30 years. International guidelines have been published. There is a real interest and we now have validated therapeutic options with drugs approved in most parts of the world, but unfortunately not available to all due to cost or location. International databases have been created and analysed and tumor tissue from thousands of patients stored in biobanks for research purposes.

Is it important to collaborate with other specialists in the field?

Yes, of course! Treating mesothelioma is actually a team-work. There is no magic bullet or unique solution in mesothelioma. I have been extremely lucky to work with world-class mesothelioma oncology experts when I was practicing in London: Prof. Mary O’Brien and Prof. Sanjay Popat from Royal Marsden Hospital, Prof. Dean Fennell from the University of Leicester, Prof. Peter Szlosarek and Dr Jeremy Steele from Barts, and also to benefit from the expertise of my friend Prof. Andrew Nicholson, Chief of Pathology at Royal Brompton Hospital and National Heart and Lung Institute-Imperial College, who was analyzing all my surgical specimens and organizing the molecular testing. All my patients have benefited from their input or direct help and services. Year after year, I have met colleagues, exchanged ideas, tried new procedures. I have been lucky to learn from pulmonologists, oncologists or surgeons like Joe Friedberg, Dan Sterman, Raja Flores, Marc de Perrot, Paul Van Schil, Jan Van Meerbeeck, Paul Baas, Arnaud Scherpereel and many others. The key is to be curious, never give up and always believe you can do better, be open to new concepts or revisit old ideas. I have also learned from experts in traditional Chinese medicine, from experts in nutrition and microbiota, and recently from experts in circadian medicine. It is important to integrate all this knowledge to be able to find out the best options for each patient. It is also important to listen to others and confront ideas, learn from your own (honest) mistakes.

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Why choose you and your colleagues for mesothelioma treatment?

 

We have consistently achieved the lowest mortality worldwide in mesothelioma surgery over the past 20 years (nil) and our long-term outcomes have always been in the top 10 percent, thanks to our highly experienced and dedicated staff and colleagues. My pride is to have been able to offer many of my patients hope and many years of valuable time with friends and families, when many had been offered nothing or just a few weeks or months to live.

We offer world-class treatments in state-of-the art modern hospital facilities conveniently located near Geneva international airport. We always do our best for our patients and we are often able to go the extra mile when no more therapeutic options have been offered elsewhere. We do not work with strict targets or guidelines. We believe that each patient is different and therefore patients should be offered personalized therapies based on advanced diagnostic technologies and biomarkers as one size does not fit all. We believe in a global approach against cancer, where not only surgery, but also systemic therapies, immunotherapy, radiation therapies, nutrition and holistic approaches are used to optimize the patient’s immune system and mindset against cancer.