Dr. David Sugarbaker, one of the most renowned mesothelioma specialists, died Aug. 29, 2018. He was 65.
The thoracic surgeon, known to many in the mesothelioma community as "Mr. Mesothelioma," leaves behind a legacy of mentoring countless mesothelioma doctors across the nation, creating research programs that are pushing for a cure to mesothelioma and improving treatment advances that have helped patients live longer lives.
Although Sugarbaker had moved almost 2,000 miles away from the well-known mesothelioma program he built in Boston, his commitment to patients and fighting this cancer was stronger than ever before.
As the former director of the Lung Institute at the Baylor College of Medicine in Houston, he built a multidisciplinary program that combined a mesothelioma research institute with an unmatched clinical practice.
Sugarbaker, who was also chief of general thoracic surgery at Baylor, developed his reputation through the previous 25 years he had spent at Brigham and Women's. During his tenure at that hospital, he refined the extrapleural pneumonectomy, an aggressive surgery that removes a cancerous lung, the lining around the lung and heart, along with nearby lymph nodes and a portion of the diaphragm.
His work as a surgical innovator helped lower the operative mortality rate, extended the lives of many patients and moved the mesothelioma community closer to finding a cure.
Sugarbaker earned the respect of his peers and patients, many of whom travel across the country and from around the world to be part of his work.
It's an opportunity to take all that I've learned [in Boston] and do it on a bigger scale now," Sugarbaker told Asbestos.com. "This is a chance to do something that could really benefit the entire mesothelioma community in a major way.
Dr. David Sugarbaker
Former Director of Lung Institute at Baylor College of Medicine, Chief of General Thoracic Surgery
"He is Mr. Mesothelioma," said fellow surgeon Abraham Lebenthal, who worked alongside Sugarbaker at Brigham and Women's Hospital in Boston. "In this field, he is the gold standard. I don't think you'll get any argument on that." As chief of the division of thoracic surgery at Brigham, Sugarbaker made this cancer the center of his focus for many years, pioneering the multimodal treatment approach that combines surgery with radiation and chemotherapy.
While in Boston, he founded and directed the International Mesothelioma Program — the largest of its kind. The program's research, clinical and support divisions attracted medical staff and patients to Boston from around the world. He expected his efforts in Texas to have a similar magnetic effect, only on a larger scale, opening the door for new research efforts that could bring everyone closer to a cure.
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His laboratories have successfully identified specific gene ratios in tumors caused by this asbestos-related disease, helping researchers gain a deeper knowledge of the disease and its clinical subtypes. His efforts also have led to personalized therapies for individual patients, moving away from the ineffective, one-size-fits-all approach to mesothelioma treatment.
"We are in the midst of a worldwide epidemic of mesothelioma, both in the United States and in Europe, where the epidemic is not expected to peak until 2020," Sugarbaker said.
Considered one of the foremost experts on the disease, Sugarbaker was involved in the early studies of frozen samples of mesothelioma, which identified particular molecular markers specific to the disease. The findings aided the search for earlier diagnoses among patients who had been exposed to asbestos, the only known cause of the illness.
Sugarbaker attended Cornell University Medical School. He completed his surgical residency at Brigham and Women's and his cardiothoracic training at Toronto General Hospital. He returned to Brigham as a surgeon in 1988, opening the door to his interest in the asbestos-related cancer.
Various medical journals have published his medical and scientific studies on extending the lives of mesothelioma patients and giving them more hopeful treatment options.
Sugarbaker's interests also included general thoracic surgery, video-assisted thoracic surgery, minimally invasive surgery, lung volume reduction surgery, non-small cell cancer and esophageal cancer.
Watch: An exclusive Asbestos.com interview with Dr. David Sugarbaker the leading mesothelioma expert, from January 2018 discussing the disease, its treatment, improving survival and the importance of finding a mesothelioma specialist.
2012 Interview with Dr. Sugarbaker
It was no accident that David Sugarbaker, newly-appointed director of the Lung Institute at Baylor College of Medicine, became one of the world's most noted authorities on mesothelioma.
He was born and raised into it.
Sugarbaker was one of 10 children, five of whom became doctors. Growing up in Jefferson City, Missouri, they would listen to their father talk passionately every night about the need to help those with cancer.
That was almost 50 years ago.
The challenge of cancer was a daily discussion at our dinner table. He was a surgeon. And he never quit trying to find better ways to help his patients. It was an inspiration for me at a very young age," Sugarbaker told Asbestos.com. "He played a big part in this.
Dr. Sugarbaker
Former Director of Lung Institute at Baylor College of Medicine, Chief of General Thoracic Surgery
Life Lessons Form the Surgeon
Sugarbaker, who founded the acclaimed International Mesothelioma Program (IMP) in Boston in 2002, turned some of his early life lessons into a career that has played a major role in improving the treatment of those afflicted with this deadly disease.
His preparation for battling mesothelioma didn't start at Cornell University Medical College, where he graduated in 1979, or when he arrived at Brigham and Women's Hospital in 1988. It started at home long before, listening to his father, working on the family's 16-acre apple orchard in Jefferson City, along with all those brothers and sisters.
"There is a lot of work to do in the winter, spring and summer when you're running an apple farm, and very little positive reinforcement," he said. "You have to have faith that there will be a return [in the fall]. The ability to work a long time without anything positive, that's something I learned at home. You had to believe. It played a very significant role in my outlook [with mesothelioma]."
Despite the history of frustration and disappointment, there still is no cure for mesothelioma.
Room for Hope
But Sugarbaker believes there is now hope for one in the future. It's one of the reasons he left a comfortable position in Boston to build a Lung Institute in Texas that will include a Mesothelioma Research Institute designed to move closer to a cure. He expects it to become bigger and better than the IMP, which already combines a state-of-the-art clinical research facility with a multimodality treatment approach. In Texas, he will have more resources available.
Sugarbaker left Boston in 2014, leaving behind a program that should continue to thrive under new leadership. He has turned his attention and leadership skills to Texas, where he hopes to have similar success with mesothelioma and other lung diseases.
"As I say to patients, when hope is part of the equation, anything is possible," he said. "I remain optimistic that we can, in the next decade, put together the right combination of patients and treatments to effect a cure, which is our holy grail."
Sugarbaker immersed himself in the cancer fight upon his arrival at Brigham and Women's. The nearby shipyards around the Boston area, and the longtime exposure to asbestos there, had produced an inordinate amount of mesothelioma patients for him to handle. And they were dying quickly.
"Early in my career, it was laid at my doorstep," he said. "And I took it as a challenge. Although it was a difficult cancer to treat, with relatively poor outcomes, you had to stick with it. When we started making significant strides, I was drawn to that."
The IMP grew rapidly, attracting some of the brightest and best from a variety of fields, drawn by the collaborative approach of an international program directed by Sugarbaker. He hopes the same can happen at Baylor.
"I tell them [young doctors] that this disease before us is like a block of solid granite," he said. "To try and break it, you can swing a broad pick and get nowhere. Or you can narrow your point and chip away at it. Make progress. Narrowing your focus is one of the keys."
After I was diagnosed in 2012, Asbestos.com reassured me that Boston was the right place to go and Dr. David Sugarbaker was the right specialist to see.
Emily Ward
Diagnosed with pleural mesothelioma in 2012
Patients Living Longer Than Before
Sugarbaker still finds motivation within the success stories of his patients, taking pride in every small step that is taken toward the goal of finding a cure. He also believes that quality life extension is the road to reaching it.
"There are people now more than 10 years out [from diagnosis of mesothelioma]. There are multiple ones three to five years out," he said. "When you're staring mesothelioma in the face and given six months to live, then seeing others a few years out, hope springs up. The fact that someone has gone through it, done it, speaks louder to patients than anything I or other so-called experts could say."
Sugarbaker's peers and patients view him today as a leader in the field. He often serves as a featured speaker at various cancer seminars, and even appeared in an episode of ABC's "Boston Med" that featured the treatment of a mesothelioma patient.
Yet, he also still reverts back to his earlier days, listening to his father, who would come home talking about his patients and the motivation they provided.
"Rather than take pride in what we do, there is really more a sense of amazement with these patients," he said. "People are told there is no hope, yet they are willing to plow forward, looking for answers. Their courage never seems to wane. That's inspiring to me."
Publications by Dr. Sugarbaker
Sugarbaker, D. J., et al. (2013). Hyperthermic intraoperative pleural cisplatin chemotherapy extends interval to recurrence and survival among low-risk patients with malignant pleural mesothelioma undergoing surgical macroscopic complete resection. The Journal of thoracic and cardiovascular surgery, 145(4), 955-963. Retrieved from https://www.sciencedirect.com/science/article/pii/S002252231201584X
Sugarbaker, D. J., et al. (2008). Transcriptome sequencing of malignant pleural mesothelioma tumors. Proceedings of the National Academy of Sciences, 105(9), 3521-3526. Retrieved from https://www.pnas.org/content/105/9/3521.short
Sugarbaker, D. J. (2006). Macroscopic complete resection: the goal of primary surgery in multimodality therapy for pleural mesothelioma. Journal of Thoracic Oncology, 1(2), 175-176. Retrieved from http://www.jto.org/article/S1556-0864(15)31536-7/abstract
Sugarbaker, D. J., et al. (1999). Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results in 183 patients. The Journal of thoracic and cardiovascular surgery, 117(1), 54-65. Retrieved from http://www.semtcvspeds.com/article/S0022-5223(99)70469-1/fulltext
Sugarbaker, D. J., & Norberto, J. J. (1998). Multimodality management of malignant pleural mesothelioma. Chest, 113(1), 61S-65S. Retrieved from http://journal.chestnet.org/article/S0012-3692(15)47596-8/abstract
Sugarbaker, D. J., et al. (1996). Extrapleural pneumonectomy in the multimodality therapy of malignant pleural mesothelioma. Results in 120 consecutive patients. Annals of surgery, 224(3), 288. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1235368/
Sugarbaker, D. J., Jaklitsch, M. T., & Liptay, M. J. (1995). Mesothelioma and radical multimodality therapy: who benefits?. Chest, 107(6), 345S-350S. Retrieved from http://journal.chestnet.org/article/S0012-3692(15)47946-2/abstract
Sugarbaker, D. J., et al. (1993). Node status has prognostic significance in the multimodality therapy of diffuse, malignant mesothelioma. Journal of Clinical Oncology, 11(6), 1172-1178. Retrieved from http://ascopubs.org/doi/abs/10.1200/jco.1993.11.6.1172
Sugarbaker, D. J., Mentzer, S. J., & Strauss, G. (1992). Extrapleural pneumonectomy in the treatment of malignant pleural mesothelioma. The Annals of thoracic surgery, 54(5), 941-946. Retrieved from http://www.annalsthoracicsurgery.org/article/0003-4975(92)90654-M/fulltext
Common Questions About Dr. David Sugarbaker
Why was Dr. David Sugarbaker known as "Mr. Mesothelioma"?
Dr. David Sugarbaker was known as "Mr. Mesothelioma" for his extensive knowledge of mesothelioma cancer and the development of treatments that would become the gold standard of medical care.
Is Dr. David Sugarbaker related to Dr. Paul Sugarbaker?
Dr. Paul H. Sugarbaker is the brother of Dr. David Sugarbaker. Paul Sugarbaker specializes in peritoneal mesothelioma and has developed the Sugarbaker Procedure, used across the world to treat this abdominal cancer. David Sugarbaker worked to establish new surgical methods for patients with pleural mesothelioma that would vastly improve patient survival.
