Thorough review leads to individualized plan of action
By Mary Brolley
The news is sobering, stunning.
“All our patients are stage IV,” says Jean-Nicolas Vauthey, M.D., professor in the Department of Surgical Oncology and eminent liver surgeon. Physician assistant Steven Wei nods.
Quality time with patients is key
Vauthey mentions “the valued moment” when he meets a patient for the first time. “We have just 15 to 45 minutes. There’s a lot to say, and I want it to be quality time.” So he relies on Wei to do the advance work that will make the appointment both productive and reassuring.
“My role is to prepare for the weekly clinic by researching each patient’s case, then summarizing it for Dr. Vauthey,” Wei says. Then, just before clinic, Vauthey, Wei and a group of surgical and research fellows gather to review each patient’s diagnosis and discuss strategy.
“We look at all the scans, talk about them,” Wei says. “We might page the radiologist to ask a question or even pose a challenge.”
“And because we can review each patient’s complete history, it’s not a snapshot, it’s dynamic over time,” Vauthey adds.
“Before we meet the patient, it’s an objective assessment,” Wei says. “Afterward, it’s more subjective, an individualized plan of action.”
More than one surgical approach
The team has pioneered several innovative surgical approaches. One is two-stage liver surgery, which minimizes the trauma to the patient and allows the liver to heal before a final surgery.
And since two-thirds of their cases are secondary cancers — usually metastases from colorectal cancer — another emerging practice is the reverse approach, where the metastasis to the liver is removed before the tumors in the primary location.
Vauthey and Wei are proud of their team’s record of success. “We’re focused,” Vauthey says. “We publish all the time — and immediately update our treatments based on our findings.” Most of all, he wants patients to know that the team is focused on their particular case.
“Often patients think they must rush into surgery, when perhaps starting with chemotherapy might be best,” he says. “I tell them, ‘Cancer is an emergency of the mind.’ We try to calm their anxiety.”