The Division of Surgical Oncology and Endocrine Surgery participates in five multidisciplinary disease management programs: Breast Diseases, Endocrine Disorders, Gastrointestinal Malignancies, Melanoma and Cutaneous Malignancies, and Sarcoma and Soft Tissue Tumors. The clinical practice in these areas has grown significantly over the past few years, largely due to the addition of several outstanding faculty members.
Specific Clinical Programs
Faculty Members: R. Daniel Beauchamp, M.D., Ana Grau, M.D., Mark C. Kelley, M.D., and Ingrid M. Meszoely, M.D. The Division of Surgical Oncology provides leadership for the surgical management of breast diseases and breast cancer. This includes participation in the multidisciplinary disease management teams for breast cancer and the breast cancer clinical research team. Patient care is provided at the Vanderbilt Breast Center, a multidisciplinary breast center that offers integrated diagnostic and clinical evaluation for patients with all types of breast diseases. In July of 2005, Dr. Meszoely assumed the position of Clinical Director of the Vanderbilt Breast Center, which had been held by Dr. Kelley for the past 8 years. During FY 2005, a multidisciplinary breast cancer clinic was instituted to provide breast cancer patients with the opportunity to be evaluated by surgical, medical and radiation oncology, breast imaging, and plastic surgery on the same day and obtain a multidisciplinary consultation regarding all aspects of breast cancer care in a single clinic visit. Under Dr. Meszoely’s direction, a dedicated high-risk clinic has been developed to perform breast cancer risk evaluation including genetic counseling and testing through the Family Cancer Risk Service, as appropriate. This clinic provides patients with comprehensive evaluation and management of breast cancer risk and facilitates participation in early diagnosis and prevention trials. Both of these clinics have been very well received by patients and referring providers, and we are considering expanding capacity in both clinics over the next year.
Several unique clinical programs for breast diseases were also developed or expanded during FY 2005. Examples include working with our colleagues in breast imaging to expand the availability of dynamic contrast-enhanced breast MRI and MRI-guided breast biopsy. We also initiated plans to begin partial breast radiotherapy with the MammositeR catheter and expand the use of intra-operative ultrasound and ultrasound-guided breast excisions in FY 2006. It is anticipated that these changes will expand the specialized clinical services available to patients at the Vanderbilt Breast Center, improve efficiency, and increase patient satisfaction.
Faculty Members: Naji Abumrad, M.D., Eugene P. “Chip” Chambers, M.D., and John Phay, M.D. Endocrine Surgeons in the Division provide leadership for the surgical management of benign and malignant endocrine disorders. Working closely with colleagues in endocrinology, they are involved in the diagnostic evaluation and management of patients with thyroid, parathyroid and adrenal disorders. During FY 2005, we expanded the use of specialized endocrine surgical procedures such as minimally invasive radioguided parathyroidectomy, intraoperative PTH and thyroglobulin evaluation, and laparoscopic adrenalectomy. We anticipate purchasing ultrasound units to be available in the endocrine clinic and operating rooms during FY 2006, which will allow us to expand the use of diagnostic ultrasound of the thyroid, parathyroid, and cervical nodes and ultrasound-guided biopsy in these areas. These enhancements will improve patient care and satisfaction by enhancing the accuracy and efficiency of the diagnostic evaluation.
Faculty Members: R. Daniel Beauchamp, M.D., Nipun B. Merchant, M.D., Ingrid M. Meszoely, M.D., and Alexander Parikh, M.D. The Division of Surgical Oncology provides leadership for the multidisciplinary disease management team for GI malignancies and the GI oncology clinical research team. Patient care is provided at the Vanderbilt Cancer Clinic that offers integrated evaluation of patients with complex GI malignancies by surgical, medical and radiation oncology, gastroenterology, and interventional radiology. In collaboration with our colleagues in general, colorectal, hepatobiliary, and thoracic surgery, we provide surgical care for patients with pancreatic, colorectal, gastric, esophageal, and hepatobiliary malignancies. During FY 2005, we were fortunate to recruit Dr. Alexander Parikh to enhance our clinical program in GI malignancies. Dr. Parikh has expertise in minimally invasive surgical techniques for gastrointestinal malignancies, including staging laparoscopy, laparoscopic gastric resection, and laparoscopic colectomy. It is anticipated that Dr. Parikh will expand the availability of these specialized surgical procedures, as well as intraoperative ultrasound and radiofrequency ablation of gastrointestinal and hepatic malignancies.
Melanoma and Cutaneous Malignancies
Faculty Members: R. Daniel Beauchamp, M.D., Mark C. Kelley, M.D., and Ingrid M. Meszoely, M.D. The Division of Surgical Oncology provides leadership for the multidisciplinary management team for melanoma and cutaneous malignancies and the melanoma clinical research team. Care is provided at the Vanderbilt Cancer Clinic offering integrated evaluation of melanoma patients by surgical and medical oncology, plastic surgery, and radiation oncology as needed. During FY 2005, the volume of melanoma cases increased dramatically, with over 300 surgical procedures performed for melanoma, and approximately 250 new analytical cases of melanoma treated at the Vanderbilt-Ingram Cancer Center. We also inaugurated the multidisciplinary melanoma conference during this year, which provides a forum for the discussion of complex cases of high-risk, recurrent, or metastatic melanoma. During FY 2006, we plan to expand the use of ultrasound for the evaluation of regional lymph nodes and image-guided biopsy of soft tissue masses in the cancer clinic. This should increase the accuracy and efficiency of the diagnostic evaluation of patients suspected to have metastatic disease and facilitate tumor biopsy for patients in clinical trials of novel therapeutic agents. It will also allow us to integrate the use of ultrasound surveillance of the regional lymph node basin in patients at high risk of regional recurrence and to increase participation in the multi-center selective lymphadenectomy trial-II.
Sarcoma and Soft Tissue Tumors
Faculty Members: R. Daniel Beauchamp, M.D., Mark C. Kelley, M.D., and Ingrid M. Meszoely, M.D. With our colleagues in Orthopedic Oncology, the Division of Surgical Oncology provides surgical care for patients with soft tissue sarcoma and other benign and malignant soft tissue tumors. Care is provided at the Vanderbilt Cancer Clinic, a multidisciplinary clinic that offers integrated evaluation of patients with soft tissue tumors by surgical, medical and radiation oncology, and plastic surgery, as needed.
General Surgical Oncology
Faculty Members: A. Scott Pearson, M.D., (Nashville VAMC). Dr. Pearson serves as the Chief of Surgical Oncology for the Nashville VA Medical Center, where he practices general surgical oncology. Dr. Pearson provides surgical leadership for the multidisciplinary disease management teams in breast diseases, gastrointestinal malignancies, melanoma and cutaneous malignancies, and sarcoma and soft tissue tumors. Dr. J. Kenneth Jacobs, Emeritus Professor of Surgery, continues to practice endocrine surgery at the Nashville VAMC. Drs. Pearson and Jacobs provide specialized surgical care to the veteran population and serve as an invaluable role of the clinical, education, and research efforts of the Division of Surgical Oncology and Endocrine Surgery.
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