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The clinical service is comprised of four fellowship trained surgical oncologists – Drs. Edward Levine, Chief; Perry Shen,
John Stewart, and Marissa Howard-McNatt – and 4 surgical house officers, 2-3 medical students, 2 research nurses and 2 research data managers, and a tissue procurement officer. Annually, the four surgical oncologists perform over 1,000 major operative procedures and see approximately 7,500 outpatients in their new clinic in the cancer center building.
The House Staff (Residents) of the service are extensively involved in multimodality consultations for the care of cancer patients with cancer of the breast and the full spectrum of gastrointestinal malignancy from esophagus to anus, as well as melanoma and sarcoma.
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In addition to operative management this includes pre-and post-operative care. Considerable clinical expertise is available to serve patients who require cancer staging, treatment, and follow-up due to primary, recurrent or metastatic malignancies. In addition to providing resection of primary lesions, a substantial portion of clinical effort is devoted to the resection of metastatic disease; including the liver, lung, peritoneum, and lymph nodes. Extensive clinical experience in a tertiary referral setting provides the surgical know-how for dealing with rare and unusual neoplasms. A weekly multidisciplinary/multimodality surgical oncology conference, which serves as the “Tumor Board” for the institution, meets every Friday at noon. Twice monthly (Tuesday at noon) the Hepatobiliary Conference reviews current cases in a multimodality format. The surgical oncology service coordinates the Multimodality Breast Care Clinical Meeting with twice-weekly (Wednesday and Friday) meetings to review cases presenting to clinic that day in a multimodality forum.
The Surgical Oncology Service actively supports clinical trials. Clinical trials in association with the National Surgical Adjuvant Breast and Bowel Project (NSABP) and the American College of Surgeons Oncology Group (ACOSOG) are coordinated by Dr. Levine who serves as their principal investigator. Dr. Shen is currently the Chair of the Surgery Section for the CALGB. Surgical Oncology also collaborates with investigators in CALGB, RTOG, and NCI, as well as other members of the Comprehensive Cancer Center including Public Health Sciences, Gastroenterology, Cancer Biology, Radiology, Medical, and Radiation Oncology.
Research is an integral part of the surgically oncology service. Currently the faculty of the Surgical Oncology Service has over one million dollars in active extramural funding for cancer research. There is ample opportunity for research by residents and medical students. Innovative treatment with intraperitoneal hyperthermic chemotherapy for malignancies which have spread throughout the peritoneal cavity (peritoneal carcinomatosis, peritoneal mesothelioma, peritoneal sarcomatosis, and pseudomyxoma peritonei) is nationally recognized and continues to draw patients from around the country. Translational projects evaluating genetic and proteomic changes associated with malignant melanoma, cancer of the breast, GI, and hepatobiliary malignancy, as well as peritoneal carcinomatosis are ongoing. Intraoperative evaluation of sentinel lymph nodes continues to be a major effort. Dr. Shen has initiated clinical research projects evaluating innovative ways to treat primary and metastatic liver tumors. His effort has been expanded to support implantable hepatic arterial perfusion pumps in conjunction with novel ablative technologies. Dr. Stewart’s interests lie in clinical proteomics and he has active funding from the NCI as well as the Robert Wood Johnson Foundation to evaluate oncolytic virus for intracavitary therapy. Dr. Howard-McNatt’s clinical and research interest is focused upon women with cancer of the breast.
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